| Mount Carmel Guild Behavioral Health System | |
|
47 Miller St Newark NJ 07114 | |
| (973) 639-4300 | |
| (973) 596-4030 |
| Full Name | Mount Carmel Guild Behavioral Health System |
|---|---|
| Speciality | Clinic/Center |
| Location | 47 Miller St, Newark, New Jersey |
| Authorized Official Name and Position | John W. Westervelt (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9735963984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Carmel Guild Behavioral Health System 590 N 7th St Newark NJ 07107-2522 Ph: (973) 596-3984 | Mount Carmel Guild Behavioral Health System 47 Miller St Newark NJ 07114 Ph: (973) 639-4300 |
| NPI Number | 1174854749 |
|---|---|
| Provider Enumeration Date | 01/21/2010 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/18/2020 |
| Medicare PECOS PAC ID | 2668428780 |
|---|---|
| Medicare Enrollment ID | O20050322000958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174854749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (New Jersey) | Primary |
| Provider Name | Shannon Gallagher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699950527 PECOS PAC ID: 7315987666 Enrollment ID: I20050506000013 |
| Provider Name | Alexandra C Forman Chou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730231200 PECOS PAC ID: 3375643521 Enrollment ID: I20070717000459 |
| Provider Name | Abby V Kurien |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982714911 PECOS PAC ID: 5799873543 Enrollment ID: I20071113000315 |
| Provider Name | Andrea Nagy-hallett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568684199 PECOS PAC ID: 6709937154 Enrollment ID: I20090625000394 |
| Provider Name | Mark Gordin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588693642 PECOS PAC ID: 9739233727 Enrollment ID: I20090810000441 |
| Provider Name | Georgiana Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417140369 PECOS PAC ID: 6002095999 Enrollment ID: I20110125000164 |
| Provider Name | Anthony Scimone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932174737 PECOS PAC ID: 4880857044 Enrollment ID: I20120525000331 |
| Provider Name | Olayinka M Aramide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104168699 PECOS PAC ID: 3971747775 Enrollment ID: I20130918000041 |
| Provider Name | Jennifer Strauss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346362530 PECOS PAC ID: 6305071119 Enrollment ID: I20131104000738 |
| Provider Name | Diane Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245632082 PECOS PAC ID: 0345461596 Enrollment ID: I20141031001778 |
| Provider Name | Nika Dyakina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699971937 PECOS PAC ID: 0840333787 Enrollment ID: I20150120000749 |
| Provider Name | Deborah Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033589965 PECOS PAC ID: 2466761978 Enrollment ID: I20151023001927 |
| Provider Name | Claudia Arango |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578825162 PECOS PAC ID: 4981987203 Enrollment ID: I20170213001077 |
| Provider Name | Theia Smallwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932676558 PECOS PAC ID: 0547500233 Enrollment ID: I20190315000605 |
| Provider Name | Adela Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841656568 PECOS PAC ID: 5395085823 Enrollment ID: I20190320002145 |
| Provider Name | Aphie Amams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497398861 PECOS PAC ID: 3577991942 Enrollment ID: I20200318000577 |
| Provider Name | Sabrina Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790301075 PECOS PAC ID: 4880012988 Enrollment ID: I20200921002850 |
| Provider Name | Alicia Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457910622 PECOS PAC ID: 3274952445 Enrollment ID: I20201008000030 |
| Provider Name | Ernest Akwaboah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821699943 PECOS PAC ID: 9436563996 Enrollment ID: I20210126000032 |
| Provider Name | Bosede J Akilo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992101729 PECOS PAC ID: 6709291602 Enrollment ID: I20210225002604 |
| Provider Name | Ibironke A Otetubi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730773656 PECOS PAC ID: 3476953977 Enrollment ID: I20210621000188 |
| Provider Name | Karen Samaniego |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811340854 PECOS PAC ID: 2264830421 Enrollment ID: I20211004000098 |
| Provider Name | James Mccreath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457432965 PECOS PAC ID: 4587769930 Enrollment ID: I20221205001664 |
| Provider Name | Lauren Mazzarese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407318785 PECOS PAC ID: 8426495771 Enrollment ID: I20240321002342 |
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