NPIMap

Organization Active NPI

Road for Success, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Kearny, NJ
National Provider Identifier
1295386019
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
ROAD FOR SUCCESS, LLC
Practice address
9 Basin Dr Ste 190
Kearny, NJ 07032-6521
Phone
(201) 362-9360
NPI assigned
Sep 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Authorized official

Name
Mr. Nathan Crawford, LSW, LCADC, CCS
Title
Director
Phone
(201) 362-9360

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

9 Basin Dr Ste 190
Kearny, NJ 07032-6521

Mailing address

1303 Bristol Station CT Apt 1303
Carteret, NJ 07008-3092

Other identifiers 1

IdentifierTypeStateIssuer
1598214843MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Road for Success LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9 Basin Dr
Ste 190
Kearny, NJ 07032
Phone (201) 362-9360

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1295386019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 BRISTOL STATION CT APT 1303",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070083092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BASIN DR STE 190",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070326521",
            "telephone_number": "201-362-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROAD FOR SUCCESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-362-9360",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSW, LCADC, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598214843",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.