Provider Demographics
NPI:1770125643
Name:MENTAL HEALTH ACCESS POINT
Entity type:Organization
Organization Name:MENTAL HEALTH ACCESS POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:DARKASHADE
Authorized Official - Suffix:
Authorized Official - Credentials:NEUROPSYCHOLOGIST
Authorized Official - Phone:848-467-1409
Mailing Address - Street 1:114 FOREST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-2184
Mailing Address - Country:US
Mailing Address - Phone:848-467-1409
Mailing Address - Fax:
Practice Address - Street 1:114 FOREST VIEW DR
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-2184
Practice Address - Country:US
Practice Address - Phone:848-467-1409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility