Active NPI
Leading Youth Through Experience, LLC
- Community/Behavioral Health Agency
- Brick, NJ
National Provider Identifier
1225240633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 44SC04652800
- Legal business name
- LEADING YOUTH THROUGH EXPERIENCE, LLC
- Practice address
- 448 19TH Ave
Brick, NJ 08724 - Phone
- (732) 458-3201
- Fax
- (732) 458-3269
- NPI assigned
- May 6, 2007
- Reactivated
- Aug 16, 2007
- Last updated
- Aug 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jason Mark Rosenberg
- Title
- Executive Director
- Phone
- (732) 458-3201
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 44SC04652800 | NJ | Primary |
Addresses
Primary practice location
448 19TH Ave
Brick, NJ 08724
Mailing address
PO Box D
Brick, NJ 08723-0055
Phone (732) 458-3201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0061913 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Leading Youth Through Experience LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual & Developmental Disabilities Psychologist
- Freehold, NJ
- NPI 1417444076
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Clinical Social Worker
- Port Monmouth, NJ
- NPI 1831663756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178409600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187222400000",
"number": "1225240633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX D",
"city": "BRICK",
"state": "NJ",
"postal_code": "087230055",
"telephone_number": "732-458-3201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "448 19TH AVE",
"city": "BRICK",
"state": "NJ",
"postal_code": "08724",
"telephone_number": "732-458-3201",
"fax_number": "732-458-3269"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEADING YOUTH THROUGH EXPERIENCE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-06",
"last_updated": "2007-08-16",
"deactivation_date": "2007-07-17",
"reactivation_date": "2007-08-16",
"status": "A",
"authorized_official_last_name": "ROSENBERG",
"authorized_official_first_name": "JASON",
"authorized_official_middle_name": "MARK",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "732-458-3201",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NJ",
"license": "44SC04652800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0061913",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.