Healthcare Provider Details

I. General information

NPI: 1003767807
Provider Name (Legal Business Name): GARDEN STATE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 RUE AVE
POINT PLEASANT BORO NJ
08742-2951
US

IV. Provider business mailing address

810 RUE AVE
POINT PLEASANT BORO NJ
08742-2951
US

V. Phone/Fax

Practice location:
  • Phone: 973-978-5502
  • Fax:
Mailing address:
  • Phone: 973-978-5502
  • 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: ANDREW WALSH
Title or Position: OWNER
Credential:
Phone: 973-978-5502