Individual provider Active NPI

Aiyana Brotherson, LMFT

  • Marriage & Family Therapist
  • Maplewood, NJ
National Provider Identifier
1164165262
Registry record updated Apr 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
37FI00205100 Issued in NJ
Practice address
2130 Millburn Ave Ste D2
Maplewood, NJ 07040-3749
Phone
(917) 310-2662
NPI assigned
Apr 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 37FI00205100 NJ Primary

Addresses

Primary practice location

2130 Millburn Ave Ste D2
Maplewood, NJ 07040-3749

Mailing address

39 Jerome Dr
Clifton, NJ 07011-2839

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

LicenseStateTypeSpecialty
37FI00205100NJMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ibisanmi Relational Health Marriage and Family Therapy, PLLC Marriage & Family Therapist PastSince Apr 24, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650067200000",
    "number": "1164165262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 JEROME DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE STE D2",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403749",
            "telephone_number": "917-310-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERSON",
        "first_name": "AIYANA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37FI00205100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2022; 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.