NPIMap

Organization Active NPI

Peaceful Minds Therapy Center LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Maplewood, NJ
National Provider Identifier
1558106989
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
PEACEFUL MINDS THERAPY CENTER LLC
Practice address
16 Berkeley St
Maplewood, NJ 07040-3317
Phone
(908) 590-5810
NPI assigned
Jun 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Dr. Fatimata Ly-Fall, PH D.NPI 1174269179
Title
Durec
Phone
(908) 590-5810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Community/Behavioral Health Agency 251S00000X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

16 Berkeley St
Maplewood, NJ 07040-3317

Mailing address

16 Berkeley St
Maplewood, NJ 07040-3317
Phone (908) 590-5810

Other names 1

  • Peaceful Minds Therapy Center LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1558106989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BERKELEY ST",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403317",
            "telephone_number": "908-590-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BERKELEY ST",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403317",
            "telephone_number": "908-590-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL MINDS THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "LY-FALL",
        "authorized_official_first_name": "FATIMATA",
        "authorized_official_title_or_position": "DUREC",
        "authorized_official_telephone_number": "908-590-5810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH D."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peaceful Minds Therapy Center LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peaceful Minds Therapy Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.