Provider Demographics
NPI:1174402390
Name:GOOD MENTAL HEALTH PC
Entity type:Organization
Organization Name:GOOD MENTAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAJSA
Authorized Official - Middle Name:
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:646-256-9616
Mailing Address - Street 1:112 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2514
Mailing Address - Country:US
Mailing Address - Phone:917-209-4108
Mailing Address - Fax:
Practice Address - Street 1:112 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2514
Practice Address - Country:US
Practice Address - Phone:917-209-4108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty