Healthcare Provider Details

I. General information

NPI: 1366365801
Provider Name (Legal Business Name): COMPLETE MIND RESET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 DUNELLEN AVE
DUNELLEN NJ
08812-1028
US

IV. Provider business mailing address

725 DUNELLEN AVE
DUNELLEN NJ
08812-1028
US

V. Phone/Fax

Practice location:
  • Phone: 973-592-6899
  • Fax: 973-592-6899
Mailing address:
  • Phone: 973-592-6899
  • Fax: 973-592-6899

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: VICTOR YABIDI
Title or Position: OWNER
Credential: APN- PMHNP
Phone: 973-592-6899