Active NPI
John Opal
- Behavior Technician
- Florence, NJ
National Provider Identifier
1053908012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-56674
- Practice address
- 15 W Front St
Florence, NJ 08518-1318 - Phone
- (609) 315-5992
- NPI assigned
- Dec 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 18-56674 | NJ | Primary |
Addresses
Primary practice location
15 W Front St
Florence, NJ 08518-1318
Mailing address
15 W Front St
Florence, NJ 08518-1318
Phone (609) 315-5992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-56674 | NJ | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Learning Well for Children LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Florence, NJ
- NPI 1568760932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608768000000",
"number": "1053908012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 W FRONT ST",
"city": "FLORENCE",
"state": "NJ",
"postal_code": "085181318",
"telephone_number": "609-315-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 W FRONT ST",
"city": "FLORENCE",
"state": "NJ",
"postal_code": "085181318",
"telephone_number": "609-315-5992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPAL",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-24",
"last_updated": "2020-12-24",
"certification_date": "2020-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NJ",
"license": "18-56674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.