Healthcare Provider Details

I. General information

NPI: 1588570865
Provider Name (Legal Business Name): THE MIND SET INTEGRATED THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N FARVIEW AVE
PARAMUS NJ
07652-2759
US

IV. Provider business mailing address

25 N FARVIEW AVE
PARAMUS NJ
07652-2759
US

V. Phone/Fax

Practice location:
  • Phone: 201-208-2029
  • Fax:
Mailing address:
  • Phone: 201-208-2029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GAIL WILKINS
Title or Position: PRINCIPAL, CLINICAL DIRECTOR
Credential: LCSW
Phone: 201-208-2029