Classic Wellness Family Mental Health Practice LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CLASSIC WELLNESS FAMILY MENTAL HEALTH PRACTICE LLC

Practice address

540 North Ave Ste 3
Union, NJ 07083-7149

Phone

(718) 325-4669

NPI assigned

Jan 29, 2020

Organization subpart

No

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

Authorized official

Name

Chinenye Okoro, DNP APNNPI 1790019644

Title

Ceo

Phone

(718) 325-4669

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Chinenye Okoro

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
  • NPI 1790019644
  Medicare reassignment NPD Authorized official
• Daniel D Okoro, DNP, APN

  • Family Nurse Practitioner
  • Union, NJ
  • NPI 1023325172

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1801427810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 VICTOR AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 3",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "718-325-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC WELLNESS FAMILY MENTAL HEALTH PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "OKORO",
        "authorized_official_first_name": "CHINENYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-325-4669",
        "authorized_official_credential": "DNP APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Almira R. Churchill
• Matthew Cirelli, DPT
• City Medical of New Jersey, PC
• Classic Medical Practice
• Classic Wellness Family Medical Practice LLC
• Clear Thoughts Healthcare LLC
• Marianne Cabezas Cleary, PA-C
• Gwen Cleaves
• Clinical Laboratory Manangement, Inc
• Lorna C Co, CRNA

• Psychiatric/Mental Health Nurse Practitioner in Union, NJ
• Providers in Union, 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 29, 2020; 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.