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NPI 1356208185

NPI 1356208185 : CHOSEN PATH WELLNESS : SOUTH ORANGE, NJ

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General NPI Number Information
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    NPI Number           |    1356208185
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHOSEN PATH WELLNESS 
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Dates
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    Enumeration Date     |    01/05/2026
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    Last Update Date     |    01/05/2026
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Provider Practice Location Address
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    Address Line         |    177 VALLEY ST 
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    City                 |    SOUTH ORANGE
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    State                |    NJ
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    Zip                  |    07079-2836
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    Country              |    US
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    Telephone            |    973-544-8334
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6 BARRY DR 
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    City                 |    WEST ORANGE
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    State                |    NJ
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    Zip                  |    07052-3524
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    Country              |    US
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    Telephone            |    973-544-8334
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     TRISTAN  BROOKS 
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    Credential           |    
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    Telephone            |    973-544-8334
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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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