Healthcare Provider Details

I. General information

NPI: 1639960164
Provider Name (Legal Business Name): HEALTHY HABITS PEACEFUL MIND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E NORTHFIELD RD
LIVINGSTON NJ
07039-4801
US

IV. Provider business mailing address

7976 MEADOW RUSH LOOP
SARASOTA FL
34238-4318
US

V. Phone/Fax

Practice location:
  • Phone: 973-820-5174
  • Fax:
Mailing address:
  • Phone: 973-820-5174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBRA GILL
Title or Position: OWNER/THERAPIST
Credential: PHD
Phone: 973-820-5174