Organization
PSYCHIATRIC EDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RICHARD GAGNON JR. CRNP,PMHNP-BC, MSN (OWNER)
(856) 699-1719
Entity
Organization
Contact information
Practice address
851 DUPORTAIL RD FL 2, CHESTERBROOK, PA 19087-5575
(856) 699-1719
(856) 249-9109
Mailing address
851 DUPORTAIL RD FL 2, CHESTERBROOK, PA 19087-5575
(856) 699-1719
(856) 249-9109
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
11/24/2025
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