Organization
DARACY BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIEN OGON (CREDENTIALING MANAGER)
(856) 398-0428
Entity
Organization
Contact information
Practice address
13 LAVISTER DR, MOUNT LAUREL, NJ 08054-2641
(973) 865-2129
Mailing address
13 LAVISTER DR, MOUNT LAUREL, NJ 08054-2641
(973) 865-2129
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/26/2025
Last updated
12/05/2025
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