Healthcare Provider Details

I. General information

NPI: 1134628258
Provider Name (Legal Business Name): GRACE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2018
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1A BROOKFIELD GLEN DR
BELVIDERE NJ
07823-2854
US

IV. Provider business mailing address

1A BROOKFIELD GLEN DR
BELVIDERE NJ
07823-2854
US

V. Phone/Fax

Practice location:
  • Phone: 908-652-5311
  • Fax: 908-320-4311
Mailing address:
  • Phone: 908-652-5311
  • Fax: 908-320-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH A. PEARCE
Title or Position: OWNER
Credential: PSYD
Phone: 908-652-5311