Gracious Angels Psychiatric Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GRACIOUS ANGELS PSYCHIATRIC SERVICES LLC

Practice address

813 Irvington Ave
Hillside, NJ 07205-3105

Phone

(973) 444-8636

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stella NwachukwuNPI 1336831718

Title

Owner

Phone

(973) 444-8636

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, and the practitioner matching its NPPES authorized official.

• Stella Ijeoma Nwachukwu I

  • Psychiatric/Mental Health Nurse Practitioner
  • Hillside, NJ
  • NPI 1336831718
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1962229203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 IRVINGTON AVE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072053105",
            "telephone_number": "973-444-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 IRVINGTON AVE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072053105",
            "telephone_number": "973-444-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIOUS ANGELS PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "NWACHUKWU",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-444-8636"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martine Garcon
• Adrienne Garro, PH.D.
• God Is Able Rehabilitation LLC (Mental Illness/suboxone solution Center)
• Nancy Gonzales
• Yael Gottesman, MS, CCC-SLP
• Billoah A Greene, ACSW
• Joshua Gruber
• Guiding Light Living LLC
• Rachel A Gyamera-Fordjour
• H & a

• Psychiatric/Mental Health Nurse Practitioner in Hillside, NJ
• Providers in Hillside, 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 Sep 25, 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.