Healthcare Provider Details

I. General information

NPI: 1881455699
Provider Name (Legal Business Name): HAPPINESS ILECHUKWU PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 RARITAN RD STE 3
CRANFORD NJ
07016-3378
US

IV. Provider business mailing address

1130 RARITAN RD STE 3
CRANFORD NJ
07016-3378
US

V. Phone/Fax

Practice location:
  • Phone: 856-454-3104
  • Fax: 856-842-5298
Mailing address:
  • Phone: 856-454-3104
  • Fax: 856-842-5298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ14963500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: