Innerwave Health LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INNERWAVE HEALTH LLC

Practice address

28 Valley Rd Ste 1
Montclair, NJ 07042-2709

Phone

(201) 565-0979

NPI assigned

Nov 16, 2023

Organization subpart

No

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

Authorized official

Name

Ling Chen, APNNPI 1962903914

Title

Nurse Practitioner

Phone

(201) 565-0979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Ling Chen, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Montclair, NJ
  • NPI 1962903914
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1609641083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 VALLEY RD STE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 VALLEY RD STE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422709",
            "telephone_number": "201-565-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERWAVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "LING",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "201-565-0979",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Adult Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.