MH at Fair Lawn LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MH AT FAIR LAWN LLC

Practice address

16-01 Broadway
Fair Lawn, NJ 07410-2026

Phone

(201) 797-0001

NPI assigned

Apr 6, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James Stokes

Title

Ceo

Phone

(561) 318-4455

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1073908018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N",
            "address_2": "3RD FLOOR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-01 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102026",
            "telephone_number": "201-797-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MH AT FAIR LAWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-318-4455"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.