| Anycolor Wellness, Llc | |
|
20 Randolph Pl Ste A West Orange NJ 07052-4808 | |
| (347) 668-0107 | |
| Not Available |
| Full Name | Anycolor Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 20 Randolph Pl Ste A, West Orange, New Jersey |
| Authorized Official Name and Position | Nikita Fonarev (OWNER / PSYCHOTHERAPIST) |
| Authorized Official Contact | 3474705199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anycolor Wellness, Llc 20 Randolph Pl Ste A West Orange NJ 07052-4808 Ph: (347) 668-0107 | Anycolor Wellness, Llc 20 Randolph Pl Ste A West Orange NJ 07052-4808 Ph: (347) 668-0107 |
| NPI Number | 1629877402 |
|---|---|
| Provider Enumeration Date | 03/12/2025 |
| Last Update Date | 03/12/2025 |
| Certification Date | 03/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629877402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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