IDA VERNELIUS DAVISTYSON
NPI 1669113361
Counselor - Mental Health in Matawan, NJ
Active since April 05, 2022
About Ida Vernelius Davistyson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IDA VERNELIUS DAVISTYSON (NPI 1669113361) is an individual mental health provider in Matawan, New Jersey and active in the NPI registry since April 2022.
NPPES Registry Identity
NPI1669113361
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameIDA VERNELIUS DAVISTYSON
Location Address166 MAIN STMatawan, NJ 07747-3104
Mailing Address1 Kyle WayEwing, NJ 08628-2508 · (732) 688-9373
Phone(732) 290-9040
Sole ProprietorYes
Enumeration DateApril 5, 2022
NPPES CertifiedApril 5, 2022
✔ NPI 1669113361 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
166 MAIN ST, Matawan, NJ 07747
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Addiction (Substance Use Disorder))
166 MAIN ST
MATAWAN, NJ 07747
MATAWAN, NJ 07747
Counselor (Addiction (Substance Use Disorder))
166 MAIN ST
MATAWAN, NJ 07747
MATAWAN, NJ 07747
Counselor (Addiction (Substance Use Disorder))
166 MAIN ST
MATAWAN, NJ 07747
MATAWAN, NJ 07747
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669113361, enumerated as an "individual" on April 05, 2022.
The provider is located at 166 MAIN ST MATAWAN, NJ 07747 and the phone number is (732) 290-9040.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
