United Behavioral Healthcare Clinic LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

UNITED BEHAVIORAL HEALTHCARE CLINIC LLC

Practice address

315 Elmora Ave
Elizabeth, NJ 07208-1383

Phone

(347) 781-1567

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Islam Momen

Title

Owner

Phone

(347) 781-1567

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean M. Christie, LCSW

  • Clinical Social Worker
  • North Brunswick, NJ
  • NPI 1891912341
  Medicare reassignment NPD

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1124770698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ELMORA AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ELMORA AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081383",
            "telephone_number": "347-781-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED BEHAVIORAL HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "MOMEN",
        "authorized_official_first_name": "ISLAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-781-1567"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.