Provider Demographics
NPI:1518536754
Name:INTOUCH MENTAL WELLNESS LLC
Entity Type:Organization
Organization Name:INTOUCH MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KROSNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-421-2860
Mailing Address - Street 1:20 BANTA PL STE 208
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5606
Mailing Address - Country:US
Mailing Address - Phone:201-968-5168
Mailing Address - Fax:201-968-5169
Practice Address - Street 1:20 BANTA PL STE 208
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5606
Practice Address - Country:US
Practice Address - Phone:201-968-5168
Practice Address - Fax:201-968-5169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty