Portum Behavioral Health

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PORTUM BEHAVIORAL HEALTH

Practice address

1465 Route 31 S Ste 1101-1102
Annandale, NJ 08801-3129

Phone

(551) 306-4000

NPI assigned

Sep 9, 2024

Last updated

Jun 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adeena JacobsonNPI 1437411550

Title

Owner

Phone

(917) 882-2744

Specialties & licenses 2

Addresses

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.

• Adeena Jacobson, MSED, BCBA

  • Behavior Analyst
  • Monsey, NY
  • NPI 1437411550
  Authorized official Same address or phone

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1336975259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 ROUTE 31 S STE 1101-1102",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013129",
            "telephone_number": "551-306-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 ROUTE 31 S STE 1101-1102",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013129",
            "telephone_number": "551-306-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTUM BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "ADEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-882-2744"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dipakkumar Pravinchandra Pandya, M.D.
• Helen Jisoo Park, O.D.
• Bharatkumar R Patel, M.D
• Manisha Patel
• Pediatric Dental Associates of Clinton, P.a.
• Portum Private Practice LLC
• Portum Private Practice LLC
• Portum Wellness and Recovery
• Preferred Therapeutics, LLC
• Professional and Life Coahing Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Annandale, NJ
• Providers in Annandale, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.