Kenechukwu Ezeanya, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15281600 Issued in NJ

Practice address

100 Franklin Square Dr Ste 410
Somerset, NJ 08873-4109

Phone

(732) 558-9625

Fax

(973) 548-9450

NPI assigned

Dec 18, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holistic Psyc Provider

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerset, NJ
  • NPI 1336936996

  NJ, Single Specialty

  Medicare reassignment NPD Authorized official
• JLS Medical PC

  • Psychiatry Physician
  • Newark, NJ
  • NPI 1164007043

  NJ, Single Specialty

  Medicare reassignment NPD
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376

  NJ, Single Specialty

  Medicare reassignment NPD
• Stress Care of New Jersey, LLC

  • Community/Behavioral Health Agency
  • Matawan, NJ
  • NPI 1033433834

  NJ, Single Specialty

  Medicare reassignment NPD
• Stress Care of New Jersey, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Somerset, NJ
  • NPI 1982345567
  NPD
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1285220764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FRANKLIN SQUARE DR STE 410",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734109",
            "telephone_number": "732-558-9625",
            "fax_number": "973-548-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FRANKLIN SQUARE DR STE 410",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734109",
            "telephone_number": "732-558-9625",
            "fax_number": "973-548-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEANYA",
        "first_name": "KENECHUKWU",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15281600",
            "primary": true
        },
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "NJ",
            "license": "26NJ15281600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tolulope Fadahunsi
• Jouliana Farag, PHARMD
• Heather Farino, FNP-C

• All providers in Somerset, NJ
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.