Healthcare Provider Details

I. General information

NPI: 1144027657
Provider Name (Legal Business Name): MENTAL HEALTH ASSOCIATION OF MONMOUTH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 APPLE ST STE 110
TINTON FALLS NJ
07724-2670
US

IV. Provider business mailing address

106 APPLE ST STE 110
TINTON FALLS NJ
07724-2670
US

V. Phone/Fax

Practice location:
  • Phone: 732-542-6422
  • Fax: 732-542-2477
Mailing address:
  • Phone: 732-542-6422
  • Fax: 732-542-2477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ACHILLE DEJEAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 732-542-6422