NPIMap

Organization Active NPI

Octave Behavioral PC

  • Psychologist
  • Ewing, NJ
National Provider Identifier
1356069173
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OCTAVE BEHAVIORAL PC
Practice address
100 Charles Ewing Blvd Ste 1600
Ewing, NJ 08628-3454
Phone
(415) 360-3833
Fax
(628) 234-3068
NPI assigned
Aug 17, 2022
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Kym Everett
Title
VP, Revenue Operations
Phone
(650) 504-2289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

100 Charles Ewing Blvd Ste 1600
Ewing, NJ 08628-3454

Mailing address

625 Market St FL 15
San Francisco, CA 94105-3316
Phone (415) 360-3853

Other practice location 1

509 Main St Bldg B
Toms River, NJ 08753-7402
Phone (415) 360-3833

Other practice location 2

608 Sherwood Pkwy
Mountainside, NJ 07092-2512
Phone (415) 360-3833

Other practice location 3

499 Morris Ave
Springfield, NJ 07081-1005
Phone (415) 360-3833

National Provider Directory

National Provider Directory
Tax ID family
Octave Behavioral PA11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1356069173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MARKET ST FL 15",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053316",
            "telephone_number": "415-360-3853",
            "fax_number": "628-234-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHARLES EWING BLVD STE 1600",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283454",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Main St Bldg B",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087537402",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "608 Sherwood Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mountainside",
            "state": "NJ",
            "postal_code": "070922512",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "499 Morris Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "NJ",
            "postal_code": "070811005",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OCTAVE BEHAVIORAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "KYM",
        "authorized_official_title_or_position": "VP, REVENUE OPERATIONS",
        "authorized_official_telephone_number": "650-504-2289"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.