Healthcare Provider Details

I. General information

NPI: 1568322998
Provider Name (Legal Business Name): THE MUSIC MOMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 ASHLAND RD
SUMMIT NJ
07901-3219
US

IV. Provider business mailing address

197 ASHLAND RD
SUMMIT NJ
07901-3219
US

V. Phone/Fax

Practice location:
  • Phone: 908-312-0227
  • Fax:
Mailing address:
  • Phone: 908-312-0227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELLEN KATHERINE DE HAVILLAND
Title or Position: OWNER/DIRECTOR
Credential: MT-BC
Phone: 908-312-0227