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General NPI Number Information
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NPI Number | 1306790779
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Entity Type | Organization
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Legal Business Name | LIVWELL MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 261 PERRY ST
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City | DOVER
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State | NJ
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Zip | 07801-2021
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Country | US
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Telephone | 201-469-6913
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Fax |
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Provider Business Mailing Address
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Address Line | 261 PERRY ST
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City | DOVER
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State | NJ
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Zip | 07801-2021
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Country | US
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Telephone | 201-469-6913
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | ANDREA WAGNER
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Credential | LCSW
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Telephone | 201-469-6913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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