Kwenyan Professional Health Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

KWENYAN PROFESSIONAL HEALTH SERVICES, LLC

Practice address

200 South St
New Providence, NJ 07974-2151

Phone

(908) 516-2338

Fax

(866) 376-8262

NPI assigned

Mar 18, 2019

Organization subpart

Yes

Parent organization

KWENYAN PROFESSIONAL HEALTH SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Dr. Daniel Estrada Cassell, PH.D., MPH, PH.D., MPH

Title

President/Ceo: Administrator

Phone

(215) 432-3702

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Kwenyan and Associates6 organizations share this tax ID, including this one

Part of

Kwenyan Professional Health Services LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Kwenyan and Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ewing, NJ
  • NPI 1104260538
  NPD tax ID
• Kwenyan and Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flemington, NJ
  • NPI 1457883928
  NPD tax ID
• Kwenyan and Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ewing, NJ
  • NPI 1598196719
  NPD tax ID
• Kwenyan Professional Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phillipsburg, NJ
  • NPI 1003392374
  NPD tax ID
• Kwenyan Professional Health Services, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Phillipsburg, NJ
  • NPI 1205312766
  NPD tax ID

Locations

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552867200000",
    "number": "1609335736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HUTTON AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524803",
            "telephone_number": "609-284-5822",
            "fax_number": "866-376-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTH ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742151",
            "telephone_number": "908-516-2338",
            "fax_number": "866-376-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWENYAN PROFESSIONAL HEALTH SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KWENYAN PROFESSIONAL HEALTH SERVICES, LLC",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A",
        "authorized_official_last_name": "CASSELL, PH.D., MPH",
        "authorized_official_first_name": "DR. DANIEL",
        "authorized_official_middle_name": "ESTRADA",
        "authorized_official_title_or_position": "PRESIDENT/CEO: ADMINISTRATOR",
        "authorized_official_telephone_number": "215-432-3702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., MPH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ OFFICE OF LICENSING: OUTPATIENT MENTAL HEALTH SERVICES",
            "identifier": "101950404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kolodiy, LPC
• Marina Kostyuk, APN
• Panagiota Kousoulis, RPH
• Meredith Miller Kowalczyk, PT, DPT
• Karla Mia Kristo, PHARMD
• Kevin Joseph Lake, DMD
• Lantern Hill, Inc. (Continuing Care at Lantern Hill)
• Lisa Larson
• Brooke Laster
• Jeffrey T Leary, MD

• Mental Health Counselor in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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.