VIVID WELLNESS NPI 1063272391

NPI Information

  • NPI: 1063272391
  • Provider Name: VIVID WELLNESS
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 415 LAUREL BROOK RD
    MONTVALE, NJ
    ZIP 07645
  • Phone: (551) 497-1964

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NPI Details

VIVID WELLNESS is a mental health (including community mental health center) clinic center in Montvale, NJ. VIVID WELLNESS NPI is 1063272391. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

415 LAUREL BROOK RD
MONTVALE, NJ
ZIP 07645-746
Phone: (551) 497-1964

The provider's authorized official is John Maggio .
The authorized official title is Owner and has the following contact phone number (551) 497-1964.

The enumeration date for this NPI number is 3/21/2024 and was last updated on 3/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthNo
31041C0700XSocial WorkerClinicalNo
4207RA0401XInternal MedicineAddiction MedicineNo
52084A0401XPsychiatry & NeurologyAddiction MedicineNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
7261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes
8261QM0850XClinic/CenterAdult Mental HealthNo
9261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
10261QM1300XClinic/CenterMulti-SpecialtyNo
11363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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