Provider Demographics
NPI:1902612773
Name:BEYOND MENTAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:BEYOND MENTAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:NPPM
Authorized Official - Phone:215-681-0108
Mailing Address - Street 1:FIVE GREENTREE CENTRE 525 ROUTE 73 NORTH
Mailing Address - Street 2:STE 104
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2116 HOMER ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138
Practice Address - Country:US
Practice Address - Phone:856-259-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty