NPIMap

Organization Active NPI

NLP Behavioral Services LLC

  • Psychiatry Physician
  • Freehold, NJ
National Provider Identifier
1104969096
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MA06315000 Issued in NJ
Legal business name
NLP BEHAVIORAL SERVICES LLC
Doing business as
NLP Behavioral Services LLC
Practice address
200 Village Center Dr
Suite #7047
Freehold, NJ 07728-3197
Phone
(732) 431-8075
Fax
(732) 431-0307
NPI assigned
Feb 14, 2007
Last updated
Nov 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Authorized official

Name
Eduardo Pietri
Title
Practice Manager
Phone
(732) 431-8075

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MA06315000 NJ Primary
Geriatric Psychiatry Physician 2084P0805X MA06315000 NJ

Addresses

Primary practice location

200 Village Center Dr
Suite #7047
Freehold, NJ 07728-3197

Mailing address

PO Box 7047
Freehold, NJ 07728-7047
Phone (732) 431-8075

Other identifiers 1

IdentifierTypeStateIssuer
6887406MedicaidNJ

Other names 1

  • NLP BEHAVIORAL SERVICES LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050420000821 NJ Part B Supplier - Clinic/Group Practice 5294773297 Receives reassigned benefits from 16 practitioners
Practice locations: Freehold, NJ; Jackson, NJ

National Provider Directory

National Provider Directory

Locations

200 Village Center Dr
Unit 7047
Freehold, NJ 07728

495 Iron Bridge Rd
Ste 8
Freehold, NJ 07728
Phone (732) 294-5588

1935 Route 9
Toms River, NJ 08755
Phone (732) 557-6500

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1104969096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7047",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077287047",
            "telephone_number": "732-431-8075",
            "fax_number": "732-431-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR",
            "address_2": "SUITE #7047",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283197",
            "telephone_number": "732-431-8075",
            "fax_number": "732-431-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NLP BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "PIETRI",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "732-431-8075"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA06315000",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "MA06315000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6887406",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NLP BEHAVIORAL SERVICES LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.