NPIMap

Organization Active NPI

Great Minds ABA Therapy LLC

  • Behavior Analyst
  • Hainesport, NJ
National Provider Identifier
1235771577
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GREAT MINDS ABA THERAPY LLC
Practice address
4 Whitney PL
Hainesport, NJ 08036-6251
Phone
(856) 220-9903
NPI assigned
Oct 8, 2019
Last updated
Oct 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Mrs. Kristen Thomsen, BCBANPI 1891925400
Title
Behavior Analyst/Director
Phone
(856) 220-9903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

4 Whitney PL
Hainesport, NJ 08036-6251

Mailing address

4 Whitney PL
Hainesport, NJ 08036-6251
Phone (856) 220-9903

Other identifiers 1

IdentifierTypeStateIssuer
1-17-27369OtherBEHAVIOR ANALYST CERTIFICATION BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL centralreach.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1235771577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WHITNEY PL",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080366251",
            "telephone_number": "856-220-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WHITNEY PL",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080366251",
            "telephone_number": "856-220-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MINDS ABA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "THOMSEN",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST/DIRECTOR",
        "authorized_official_telephone_number": "856-220-9903",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-17-27369",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "centralreach.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "excel",
            "address_1": "4 Whitney Pl",
            "city": "Hainesport",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080366251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.