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General NPI Number Information
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NPI Number | 1154110492
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Entity Type | Organization
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Legal Business Name | HEARD MENTALITY
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 11 ACADIA DR
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City | VOORHEES
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State | NJ
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Zip | 08043-1600
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Country | US
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Telephone | 973-348-9989
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Fax |
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Provider Business Mailing Address
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Address Line | 701 ROUTE 70 W
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City | MARLTON
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State | NJ
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Zip | 08053-1643
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | KRISTINA ISSHAK
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Credential | MSW
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Telephone | 856-701-1278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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