| James P Nelson Behavioral Healthcare, Llc | |
|
599 S Livingston Ave Livingston NJ 07039-5425 | |
| (908) 265-6569 | |
| Not Available |
| Full Name | James P Nelson Behavioral Healthcare, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 599 S Livingston Ave, Livingston, New Jersey |
| Authorized Official Name and Position | Kyesha Headd (DIRECTOR) |
| Authorized Official Contact | 9082656569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James P Nelson Behavioral Healthcare, Llc 599 S Livingston Ave Livingston NJ 07039-5425 Ph: () - | James P Nelson Behavioral Healthcare, Llc 599 S Livingston Ave Livingston NJ 07039-5425 Ph: (908) 265-6569 |
| NPI Number | 1992378665 |
|---|---|
| Provider Enumeration Date | 07/21/2021 |
| Last Update Date | 07/21/2021 |
| Certification Date | 07/21/2021 |
| Medicare PECOS PAC ID | 0547668733 |
|---|---|
| Medicare Enrollment ID | O20211001000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992378665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kyesha L Headd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659789691 PECOS PAC ID: 4183022379 Enrollment ID: I20211012002637 |
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