Active NPI
Youth Development SVCS
- Social Worker
- Paramus, NJ
National Provider Identifier
1356645923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SC05258800
- Legal business name
- YOUTH DEVELOPMENT SVCS
- Practice address
- 12 N Rte 17
Suite 313
Paramus, NJ 07652-2644 - Phone
- (201) 543-3935
- Fax
- (201) 226-1141
- NPI assigned
- Dec 22, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Rebecca Henriquez, LCSW
- Title
- LCSW
- Phone
- (201) 543-3935
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SC05258800 | NJ | Primary |
| Home Health Agency | 251E00000X |
Addresses
Primary practice location
12 N Rte 17
Suite 313
Paramus, NJ 07652-2644
Mailing address
12 N Rte 17
Suite 313
Paramus, NJ 07652-2644
Phone (201) 543-3935
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0036587 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Youth Development Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hackensack, NJ
- NPI 1134327679
Locations
12 N State Rt 17
Ste 313
Paramus, NJ 07652
Phone (201) 368-3700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292976000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1443744000000",
"number": "1356645923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 N RTE 17",
"address_2": "SUITE 313",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076522644",
"telephone_number": "201-543-3935",
"fax_number": "201-226-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 N RTE 17",
"address_2": "SUITE 313",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076522644",
"telephone_number": "201-543-3935",
"fax_number": "201-226-1141"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUTH DEVELOPMENT SVCS",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-22",
"last_updated": "2015-10-02",
"status": "A",
"authorized_official_last_name": "HENRIQUEZ",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "LCSW",
"authorized_official_telephone_number": "201-543-3935",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NJ",
"license": "44SC05258800",
"primary": true
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0036587",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.