Provider Demographics
NPI:1134451222
Name:NAVESINK WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:NAVESINK WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-533-4224
Mailing Address - Street 1:61 CARTON ST
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1603
Mailing Address - Country:US
Mailing Address - Phone:732-533-4224
Mailing Address - Fax:
Practice Address - Street 1:61 CARTON ST
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760
Practice Address - Country:US
Practice Address - Phone:732-533-4224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty