NPIMap

Organization Active NPI

Gold Heart ABA LLC

  • Behavior Analyst
  • Jackson, NJ
National Provider Identifier
1346920162
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GOLD HEART ABA LLC
Practice address
5 Macintosh CT
Jackson, NJ 08527-1176
Phone
(631) 507-7643
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Yehoushua Tyberg
Title
Owner
Phone
(631) 507-7643

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

5 Macintosh CT
Jackson, NJ 08527-1176

Mailing address

5 Macintosh CT
Jackson, NJ 08527-1176
Phone (631) 507-7643

Other practice location 1

555 S Mangum St Ste 100
Durham, NC 27701-4689
Phone (732) 637-9359

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1346920162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MACINTOSH CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271176",
            "telephone_number": "631-507-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MACINTOSH CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271176",
            "telephone_number": "631-507-7643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 S Mangum St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277014689",
            "country_code": "US",
            "telephone_number": "732-637-9359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLD HEART ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "TYBERG",
        "authorized_official_first_name": "YEHOUSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-507-7643"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.