| Centerpath Wellness, Inc | |
|
117 Roosevelt Ave Plainfield NJ 07060-1331 | |
| (908) 756-6870 | |
| (908) 756-5566 |
| Full Name | Centerpath Wellness, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 Roosevelt Ave, Plainfield, New Jersey |
| Authorized Official Name and Position | Omar Soberal (VP REVENUE) |
| Authorized Official Contact | 7329558373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerpath Wellness, Inc 1215-1217 Main Street Asbury Park NJ 07712 Ph: (732) 955-8373 | Centerpath Wellness, Inc 117 Roosevelt Ave Plainfield NJ 07060-1331 Ph: (908) 756-6870 |
| NPI Number | 1962459552 |
|---|---|
| Provider Enumeration Date | 05/28/2006 |
| Last Update Date | 07/21/2026 |
| Certification Date | 07/21/2026 |
| Medicare PECOS PAC ID | 0042368136 |
|---|---|
| Medicare Enrollment ID | O20090429000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962459552 | NPI | - | NPPES |
| 0015105 | Medicaid | NJ | |
| 7640706 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 204050104 (New Jersey) | Primary |
| Provider Name | Maria D Wiener |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194778639 PECOS PAC ID: 1951325224 Enrollment ID: I20060125000727 |
| Provider Name | Edward L Farkas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154313955 PECOS PAC ID: 2365572799 Enrollment ID: I20100611000337 |
| Provider Name | Mary T Desane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497058275 PECOS PAC ID: 5395928022 Enrollment ID: I20110317000718 |
| Provider Name | Usman Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639533276 PECOS PAC ID: 0244658102 Enrollment ID: I20200910000059 |
| Provider Name | Olivia Gibson-delaney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881128924 PECOS PAC ID: 2961748827 Enrollment ID: I20210823000029 |
| Provider Name | Kelly Houston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275103665 PECOS PAC ID: 2961862024 Enrollment ID: I20230720002603 |
| Provider Name | Michel Estiverne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447956289 PECOS PAC ID: 6204297815 Enrollment ID: I20230730000163 |
| Provider Name | Adetutu L Soneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487013629 PECOS PAC ID: 2163954330 Enrollment ID: I20241011003549 |
| Provider Name | Rabica Shahid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437738192 PECOS PAC ID: 3375012693 Enrollment ID: I20260515002549 |
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