Provider Demographics
NPI:1063373850
Name:INNERCALM WELLNESS NJ PC
Entity type:Organization
Organization Name:INNERCALM WELLNESS NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:516-513-1256
Mailing Address - Street 1:501 S BROADWAY STE 102
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5067
Mailing Address - Country:US
Mailing Address - Phone:516-513-1256
Mailing Address - Fax:877-624-7856
Practice Address - Street 1:845 NEWARK AVENUE
Practice Address - Street 2:UNIT 1
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5195
Practice Address - Country:US
Practice Address - Phone:516-513-1256
Practice Address - Fax:877-624-7856
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INNERCALM WELLNESS NJ PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-20
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty