Individual provider Active NPI

Elizabeth A Demarco, BCBA

  • Behavior Analyst
  • Aberdeen, NJ
National Provider Identifier
1326779299
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-59936 Issued in NU
Practice address
1 Woodbrook Dr
Aberdeen, NJ 07747-1901
Phone
(732) 682-6645
NPI assigned
Jun 22, 2022
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-59936 NU Primary

Addresses

Primary practice location

1 Woodbrook Dr
Aberdeen, NJ 07747-1901

Mailing address

204 Wilson Ave
Port Monmouth, NJ 07758-1228
Phone (732) 682-6645

Other practice location 1

204 Wilson Ave
Port Monmouth, NJ 07758-1228
Phone (732) 682-6645

Other practice location 2

45 Appleton Ave
Leonardo, NJ 07737-1232
Phone (732) 682-6645

Other practice location 3

405 State Highway 36, Port Monmouth, NJ, USA
PortMonmouth, NJ 07758-0775
Phone (848) 757-2123

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MMLCfamily.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minding Miracles Learning Center Behavior Analyst CurrentSince Jun 26, 2022 Accepting new patients

Locations

1 Woodbrook Dr
Aberdeen, NJ 07747
Phone (732) 583-8704

45 Appleton Ave
Leonardo, NJ 07737
Phone (732) 291-0810

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1326779299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WILSON AVE",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581228",
            "telephone_number": "732-682-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WOODBROOK DR",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077471901",
            "telephone_number": "732-682-6645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Wilson Ave",
            "address_purpose": "LOCATION",
            "city": "Port Monmouth",
            "state": "NJ",
            "postal_code": "077581228",
            "country_code": "US",
            "telephone_number": "732-682-6645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Appleton Ave",
            "address_purpose": "LOCATION",
            "city": "Leonardo",
            "state": "NJ",
            "postal_code": "077371232",
            "country_code": "US",
            "telephone_number": "732-682-6645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 State Highway 36, Port Monmouth, NJ, USA",
            "address_purpose": "LOCATION",
            "city": "PortMonmouth",
            "state": "NJ",
            "postal_code": "077580775",
            "country_code": "US",
            "telephone_number": "848-757-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-22-59936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MMLCfamily.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "204 Wilson Ave",
            "city": "Port Monmouth",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077581228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aberdeen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.