NPIMap

Organization Active NPI

Lighthouse ABA Therapy

  • Behavior Analyst
  • Cliffside PK, NJ
National Provider Identifier
1346957818
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LIGHTHOUSE ABA THERAPY
Practice address
562 Oregon Ave
Cliffside PK, NJ 07010-1713
Phone
(973) 454-0528
NPI assigned
Nov 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Mrs. Samerh M KhalilNPI 1245122142
Title
President
Phone
(973) 454-0528

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

562 Oregon Ave
Cliffside PK, NJ 07010-1713

Mailing address

562 Oregon Ave
Cliffside PK, NJ 07010-1713
Phone (973) 454-0528

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL lighthouseabatherapy2@gmail.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Lighthouse ABA Therapy2 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.

Locations

742 Bergen Blvd
Ridgefield, NJ 07657
Phone (973) 454-0528

Practitioners & affiliated clinicians

Practitioners 6

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": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1346957818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 OREGON AVE",
            "city": "CLIFFSIDE PK",
            "state": "NJ",
            "postal_code": "070101713",
            "telephone_number": "973-454-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 OREGON AVE",
            "city": "CLIFFSIDE PK",
            "state": "NJ",
            "postal_code": "070101713",
            "telephone_number": "973-454-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE ABA THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "SAMERH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-454-0528",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lighthouseabatherapy2@gmail.com",
            "affiliation": "N",
            "endpointDescription": "lighthouseabatherapy2@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "562 Oregon Ave",
            "city": "Cliffside Pk",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070101713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cliffside PK, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.