Provider Demographics
NPI:1104493378
Name:K MENTAL WELLNESS LLC
Entity type:Organization
Organization Name:K MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP, APRN, PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:O
Authorized Official - Last Name:ASAMOAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-479-1931
Mailing Address - Street 1:100 HORIZON CENTER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1910
Mailing Address - Country:US
Mailing Address - Phone:609-479-1931
Mailing Address - Fax:609-498-6203
Practice Address - Street 1:100 HORIZON CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-1910
Practice Address - Country:US
Practice Address - Phone:609-479-1931
Practice Address - Fax:609-498-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty