| Garden State Psychiatric Services, Llc | |
|
190 N Evergreen Ave Ste 202 Woodbury NJ 08096-1862 | |
| (856) 628-4504 | |
| (856) 494-1549 |
| Full Name | Garden State Psychiatric Services, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 190 N Evergreen Ave Ste 202, Woodbury, New Jersey |
| Authorized Official Name and Position | Lisa Fulwiler (ADMINISTRATION ASSISTANT) |
| Authorized Official Contact | 8566284504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Psychiatric Services, Llc 190 N Evergreen Ave Ste 202 Woodbury NJ 08096-1862 Ph: (856) 628-4504 | Garden State Psychiatric Services, Llc 190 N Evergreen Ave Ste 202 Woodbury NJ 08096-1862 Ph: (856) 628-4504 |
| NPI Number | 1073135117 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 07/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073135117 | NPI | - | NPPES |
| 0722782 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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