Provider Demographics
NPI:1710695044
Name:HAPPY MANGO MENTAL HEALTH PC
Entity Type:Organization
Organization Name:HAPPY MANGO MENTAL HEALTH PC
Other - Org Name:ELLIE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-459-9264
Mailing Address - Street 1:286 OLD SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6056
Mailing Address - Country:US
Mailing Address - Phone:212-459-9264
Mailing Address - Fax:
Practice Address - Street 1:26 MADISON AVE STE 6
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7366
Practice Address - Country:US
Practice Address - Phone:973-490-4284
Practice Address - Fax:973-363-9616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty