# HOLISTIC PSYC PROVIDER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336936996
- **Authorized official:** KENECHUKWU EZEANYA (OWNER/CEO)
- **Authorized official phone:** (732) 558-9625

## Contact information

- **Practice address:** 100 FRANKLIN SQUARE DR STE 410, SOMERSET, NJ 08873-4109
- **Practice address phone:** (732) 558-9625
- **Practice address fax:** (973) 548-9625
- **Mailing address:** 100 FRANKLIN SQUARE DR STE 410, SOMERSET, NJ 08873-4109
- **Mailing address phone:** (732) 558-9625
- **Mailing address fax:** (973) 548-9450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/24/2025
- **Last updated:** 06/17/2026