P & Q Mental Health Clinic, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

P & Q MENTAL HEALTH CLINIC, LLC

Doing business as

P & Q Mental Health Clinic, LLC

Practice address

46 Ravine Dr
Matawan, NJ 07747-2965

Phone

(917) 753-4575

Fax

(732) 970-4956

NPI assigned

Sep 14, 2022

Organization subpart

No

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

Authorized official

Name

Oksana Libelt, PMHNP-BC

Title

Psychiatrics Nurse Practitioner

Phone

(917) 753-4575

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• P & Q Mental Health Clinic, LLC Doing business as

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1437871654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 RAVINE DR",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472965",
            "telephone_number": "917-753-4575",
            "fax_number": "732-970-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 RAVINE DR",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472965",
            "telephone_number": "917-753-4575",
            "fax_number": "732-970-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & Q MENTAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "LIBELT",
        "authorized_official_first_name": "OKSANA",
        "authorized_official_title_or_position": "PSYCHIATRICS NURSE PRACTITIONER",
        "authorized_official_telephone_number": "917-753-4575",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922564566",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P & Q Mental Health Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Matawan, NJ
• Providers in Matawan, NJ by specialty
• 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 Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.