Healthcare Provider Details

I. General information

NPI: 1134055122
Provider Name (Legal Business Name): CEPHAS MENTAL WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 SPRINGFIELD AVE STE 2
MAPLEWOOD NJ
07040-2857
US

IV. Provider business mailing address

1585 SPRINGFIELD AVE STE 2
MAPLEWOOD NJ
07040-2857
US

V. Phone/Fax

Practice location:
  • Phone: 973-370-9836
  • Fax: 973-238-5548
Mailing address:
  • Phone: 973-370-9836
  • Fax: 973-238-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARIE VOLCY
Title or Position: OWNER
Credential: APN
Phone: 973-370-9836