Northeast Behavioral Services, Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MB06828200 Issued in NJ

Legal business name

NORTHEAST BEHAVIORAL SERVICES, INC

Doing business as

Park Bench Professional

Practice address

421 Bethel Rd
Somers Point, NJ 08244-2081

Phone

(615) 567-7256

NPI assigned

Apr 11, 2016

Organization subpart

Yes

Parent organization

DAVID A SACK, MD TN PCAs reported in NPPES

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

Authorized official

Name

Cheryl Maplesden, CPC, CHC, CHPC

Title

Director, Revenue Cycle

Phone

(615) 510-3708

Specialties & licenses 3

Addresses

Other names 1

• Park Bench Professional Doing business as

Tax ID family

Northeast Behavioral Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Northeast Behavioral Servcies, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Somers Point, NJ
  • NPI 1841697034
  NPD tax ID

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1346604808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670521",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752670521",
            "telephone_number": "615-567-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BETHEL RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442081",
            "telephone_number": "615-567-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST BEHAVIORAL SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVID A SACK, MD TN PC",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "MAPLESDEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "615-510-3708",
        "authorized_official_credential": "CPC, CHC, CHPC"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NJ",
            "license": "25MA04602100",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MB06828200",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00062700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Bench Professional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie L Nelson
• New Jersey CVS Pharmacy LLC
• New Jersey CVS Pharmacy LLC
• Thu Oanh Thi Nguyen, PHARMD
• Northeast Behavioral Servcies, Inc
• Patricia Norton, CRNA
• John R Nosti, D.M.D., F.A.GD.
• Novasack Family Dental LLC
• Mark Novasack, DMD
• Milton A Noveck, D.M.D.

• Psychiatry Physician in Somers Point, NJ
• Providers in Somers Point, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.