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General NPI Number Information
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NPI Number | 1639960164
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Entity Type | Organization
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Legal Business Name | HEALTHY HABITS PEACEFUL MIND THERAPY, LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 230 E NORTHFIELD RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-4801
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Country | US
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Telephone | 973-820-5174
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Fax |
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Provider Business Mailing Address
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Address Line | 7976 MEADOW RUSH LOOP
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City | SARASOTA
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State | FL
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Zip | 34238-4318
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Country | US
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Telephone | 973-820-5174
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DR. DEBRA GILL
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Credential | PHD
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Telephone | 973-820-5174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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