Healthcare Provider Details

I. General information

NPI: 1568338564
Provider Name (Legal Business Name): BERGEN MIND & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 US HIGHWAY 202 N # 5231
BRANCHBURG NJ
08876-3757
US

IV. Provider business mailing address

516 GRANDVIEW AVE
WYCKOFF NJ
07481-2549
US

V. Phone/Fax

Practice location:
  • Phone: 908-201-6998
  • Fax:
Mailing address:
  • Phone: 908-201-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROCIO JENKINS
Title or Position: PMHNP
Credential: APN
Phone: 917-261-8250