Provider Demographics
NPI:1366324071
Name:MINDWELL BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:MINDWELL BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VYACHESLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-237-7100
Mailing Address - Street 1:1901 N OLDEN AVENUE EXT STE 29
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2111
Mailing Address - Country:US
Mailing Address - Phone:609-237-7100
Mailing Address - Fax:609-616-7904
Practice Address - Street 1:1901 N OLDEN AVENUE EXT STE 29
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2111
Practice Address - Country:US
Practice Address - Phone:609-237-7100
Practice Address - Fax:609-616-7904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINDWELL BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty