| Refresh New Jersey Psych Health Llc | |
|
2290 W County Line Rd Jackson NJ 08527-2267 | |
| (610) 544-2110 | |
| (941) 460-5599 |
| Full Name | Refresh New Jersey Psych Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2290 W County Line Rd, Jackson, New Jersey |
| Authorized Official Name and Position | Stacy Cloyd (SECRETARY) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Refresh New Jersey Psych Health Llc 1090 S Tamiami Trl Sarasota FL 34236-9116 Ph: (941) 363-0878 | Refresh New Jersey Psych Health Llc 2290 W County Line Rd Jackson NJ 08527-2267 Ph: (610) 544-2110 |
| NPI Number | 1750999066 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 1759799869 |
|---|---|
| Medicare Enrollment ID | O20210408002753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750999066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tracy Lynn Mount |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952698565 PECOS PAC ID: 7214197045 Enrollment ID: I20120402000102 |
| Provider Name | Constance Mensah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992235956 PECOS PAC ID: 7810259629 Enrollment ID: I20180314001685 |
| Provider Name | Alexandra M Howlett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649767609 PECOS PAC ID: 0547665192 Enrollment ID: I20210820000989 |
| Provider Name | Samantha Michelle Notaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720754658 PECOS PAC ID: 9133525959 Enrollment ID: I20210902001548 |
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