LD Behavioral and Support Services

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Legal business name

LD BEHAVIORAL AND SUPPORT SERVICES

Doing business as

LD Behavioral and Support Services

Practice address

50 W South Orange Ave
South Orange, NJ 07079-1730

Phone

(201) 486-3367

Fax

(973) 378-9525

NPI assigned

Jun 14, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Edna Yolanda Lee, REGISTERED NURSE

Title

Ceo/Owner

Phone

(201) 486-3367

Specialties & licenses 2

Addresses

Other names 1

• LD Behavioral and Support Services Doing business as

Locations

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1184308793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792806",
            "telephone_number": "201-486-3367",
            "fax_number": "973-378-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W SOUTH ORANGE AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791730",
            "telephone_number": "201-486-3367",
            "fax_number": "973-378-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LD BEHAVIORAL AND SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "EDNA",
        "authorized_official_middle_name": "YOLANDA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "201-486-3367",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LD Behavioral and Support Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Larkin
• Safia Latif, PHARM.D
• Jennifer Lau, MPT
• Eugenia Lavanant
• Wendy J Lazarus
• Learning for Life Development Center, LLC
• Chenghui Lee
• Clyde Lee III
• Shirley Lee
• Nina Lerner, L.C.S.W.

• School Psychologist in South Orange, NJ
• Providers in South Orange, NJ by specialty
• School Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.