# MELLOWMINDS PSYCHIATRIC SERVICES LLC

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

## Provider details

- **NPI number:** 1538953658
- **Authorized official:** KELLY PEREZ PMHNP-BC (PMHNP-BC)
- **Authorized official phone:** (908) 472-5871

## Contact information

- **Practice address:** 193 TERRILL RD, FANWOOD, NJ 07023-1055
- **Practice address phone:** (908) 472-5871
- **Mailing address:** 26 MARY LN, FANWOOD, NJ 07023-1009
- **Mailing address phone:** (908) 472-5871

## 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:** 04/04/2025
- **Last updated:** 04/04/2025