Healthcare Provider Details

I. General information

NPI: 1124902705
Provider Name (Legal Business Name): HEALING HEARTS HEALING MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 OLD HOOK RD # E109
EMERSON NJ
07630-2301
US

IV. Provider business mailing address

436 OLD HOOK RD # E109
EMERSON NJ
07630-2301
US

V. Phone/Fax

Practice location:
  • Phone: 201-936-1315
  • Fax: 201-603-7328
Mailing address:
  • Phone: 201-936-1315
  • Fax: 201-603-7328

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: MS. ODETTA R SUAREZ
Title or Position: ADVANCED PRACTICE NURSE
Credential: PMHNP-BC, FNP-BC
Phone: 201-218-7473