Blair Polhemus, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-66424 Issued in NJ

Practice address

1970 Swarthmore Ave Ste 4
Lakewood, NJ 08701-4553

Phone

(908) 675-0029

NPI assigned

Jul 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Blair Berardesco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Brighter Futures ABA LLC

  • Community/Behavioral Health Agency
  • Forked River, NJ
  • NPI 1801683214
  NPD Authorized official

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1245919786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 EARIE WAY",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087314057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 SWARTHMORE AVE STE 4",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014553",
            "telephone_number": "908-675-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLHEMUS",
        "first_name": "BLAIR",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-23-66424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAIR",
            "last_name": "BERARDESCO",
            "prefix": "MISS",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Plotnik
• Eliezer Plumer, LSW
• Perel Plutchok, MA, SLP, CF
• Rebecca Rachel Plutchok, PA-C
• Stuart Jeffrey Podob, DC
• Joseph Polinsky, D.M.D.
• Tova E Pollack, LMSW
• Chana Pollak, RN
• Chaya Pollak, LSW
• Yocheved Pollak, MS

• Behavior Analyst in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.