Healthcare Provider Details

I. General information

NPI: 1477473098
Provider Name (Legal Business Name): NEW JERSEY PSYCHIATRIC WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTH AVE EAST #2
WESTFIELD NJ
07090
US

IV. Provider business mailing address

506 W MOUNT PLEASANT AVE STE 1050
LIVINGSTON NJ
07039-1701
US

V. Phone/Fax

Practice location:
  • Phone: 732-646-8364
  • Fax:
Mailing address:
  • Phone: 732-646-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE GINA MAINARDI
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 732-646-8364