Healthcare Provider Details

I. General information

NPI: 1649963414
Provider Name (Legal Business Name): HEADWAY NEW JERSEY BEHAVIORAL HEALTH SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

IV. Provider business mailing address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

V. Phone/Fax

Practice location:
  • Phone: 646-453-6777
  • Fax: 929-596-7897
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CARY S. CRALL
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: MD
Phone: 646-453-6777