| Mindwell Behavioral Health | |
|
1901 N Olden Avenue Ext Ste 29 Ewing NJ 08618-2111 | |
| (609) 237-7100 | |
| (609) 616-7904 |
| Full Name | Mindwell Behavioral Health |
|---|---|
| Speciality | Counselor |
| Location | 1901 N Olden Avenue Ext Ste 29, Ewing, New Jersey |
| Authorized Official Name and Position | Armen Grigoryan (CEO) |
| Authorized Official Contact | 6092377100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindwell Behavioral Health 1901 N Olden Avenue Ext Ste 29 Ewing NJ 08618-2111 Ph: (609) 237-7100 | Mindwell Behavioral Health 1901 N Olden Avenue Ext Ste 29 Ewing NJ 08618-2111 Ph: (609) 237-7100 |
| NPI Number | 1750037891 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 02/28/2022 |
| Certification Date | 02/28/2022 |
| Medicare PECOS PAC ID | 4880080266 |
|---|---|
| Medicare Enrollment ID | O20220412001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750037891 | NPI | - | NPPES |
| Provider Name | Beatrice C Iloka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174903751 PECOS PAC ID: 1052618857 Enrollment ID: I20160322001677 |
| Provider Name | Liju Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477948578 PECOS PAC ID: 1951606714 Enrollment ID: I20160428000853 |
| Provider Name | Nancy Jean Hadley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972552693 PECOS PAC ID: 3870888449 Enrollment ID: I20160822000563 |
| Provider Name | Elizan Manuel Morales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649820069 PECOS PAC ID: 5991178980 Enrollment ID: I20230221003351 |
| Provider Name | Ophelia Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013637404 PECOS PAC ID: 2365816998 Enrollment ID: I20230323000125 |
| Provider Name | Eronmwon Balogun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013699693 PECOS PAC ID: 2163879651 Enrollment ID: I20231105000084 |
| Provider Name | Benita Denice James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639932924 PECOS PAC ID: 9032651666 Enrollment ID: I20240611001427 |
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