Health and Wellness Behavioral Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HEALTH AND WELLNESS BEHAVIORAL SERVICES

Practice address

134 Evergreen PL Ste 503
East Orange, NJ 07018-2010

Phone

(201) 957-1119

Fax

(201) 367-2438

NPI assigned

Jan 10, 2024

Organization subpart

No

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

Authorized official

Name

Osagie Mary

Title

Owner/Apn

Phone

(201) 957-1119

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.

• Mary O Osagie

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, NJ
  • NPI 1508564097
  Medicare reassignment NPD
• Christopher T Tikum

  • Psychiatric/Mental Health Nurse Practitioner
  • East Orange, NJ
  • NPI 1578269056
  NPD

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723248000000",
    "number": "1871364851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CLAIRMONT TER",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070503144",
            "telephone_number": "201-957-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 EVERGREEN PL STE 503",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182010",
            "telephone_number": "201-957-1119",
            "fax_number": "201-367-2438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071031303",
            "country_code": "US",
            "telephone_number": "201-957-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTH AND WELLNESS BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A",
        "authorized_official_last_name": "MARY",
        "authorized_official_first_name": "OSAGIE",
        "authorized_official_title_or_position": "OWNER/APN",
        "authorized_official_telephone_number": "201-957-1119"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in East Orange, NJ
• Providers in East Orange, 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 Aug 10, 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.