Provider Demographics
NPI:1992484943
Name:FORWARD THINKING MENTAL WELLNESS
Entity type:Organization
Organization Name:FORWARD THINKING MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:ROSSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC
Authorized Official - Phone:201-838-0098
Mailing Address - Street 1:760 US HIGHWAY 46 # 1061
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3401
Mailing Address - Country:US
Mailing Address - Phone:201-419-5308
Mailing Address - Fax:
Practice Address - Street 1:16 SHAWNEE AVE
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1505
Practice Address - Country:US
Practice Address - Phone:201-419-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty