MEDICARE: HEAD TO HEALTH PSYCHIATRY, LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1083441026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAD TO HEALTH PSYCHIATRY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 144
Second Line	:
City	:	ADELPHIA
State	:	NJ
Zip	:	07710-0144
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 SOUTH ST UNIT B1
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-2164
Country	:	US
Telephone Number	:	732-637-9205
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LORI PRICE
Credential	:	APN
Telephone Number	:	732-637-9205

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	10/28/2024

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