Individual provider Active NPI

Destinie Vandergrift, BCBA

  • Behavior Analyst
  • Woodbury, NJ
National Provider Identifier
1104717982
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-70926 Issued in NJ
Practice address
17 W Red Bank Ave Ste 103
Woodbury, NJ 08096-1630
Phone
(856) 480-0688
NPI assigned
Jul 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-70926 NJ Primary

Addresses

Primary practice location

17 W Red Bank Ave Ste 103
Woodbury, NJ 08096-1630

Mailing address

117 Spruce Ave
Westville, NJ 08093-1119
Phone (856) 625-1123

Other names 1

  • Destinie Cubler Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1104717982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SPRUCE AVE",
            "city": "WESTVILLE",
            "state": "NJ",
            "postal_code": "080931119",
            "telephone_number": "856-625-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE STE 103",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-480-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFT",
        "first_name": "DESTINIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-24-70926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESTINIE",
            "last_name": "CUBLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.