Healthcare Provider Details

I. General information

NPI: 1457852154
Provider Name (Legal Business Name): CRP BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 MCCLELLAN ST
LONG BRANCH NJ
07740-5835
US

IV. Provider business mailing address

642 MCCLELLAN ST
LONG BRANCH NJ
07740-5835
US

V. Phone/Fax

Practice location:
  • Phone: 732-443-4880
  • Fax: 732-443-4884
Mailing address:
  • Phone: 732-443-4880
  • Fax: 732-443-4884

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: CHRISTINE POSSEMATO
Title or Position: PMHNP
Credential: APN
Phone: 732-443-4880