MEDICARE: GARDEN STATE BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1003767807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDEN STATE BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	810 RUE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2951
Country	:	US
Telephone Number	:	973-978-5502
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 RUE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2951
Country	:	US
Telephone Number	:	973-978-5502
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW WALSH
Credential	:
Telephone Number	:	973-978-5502

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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