Healthcare Provider Details

I. General information

NPI: 1336069004
Provider Name (Legal Business Name): MIND SPA & MORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SPEEDWELL AVE STE 109
MORRIS PLAINS NJ
07950-2132
US

IV. Provider business mailing address

PO BOX 104
MORRIS PLAINS NJ
07950-0104
US

V. Phone/Fax

Practice location:
  • Phone: 908-914-8156
  • Fax:
Mailing address:
  • Phone: 973-670-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAPHNE SHALITA
Title or Position: PRESIDENT
Credential: PHD
Phone: 973-670-4393