Brain Life Connection LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BRAIN LIFE CONNECTION LLC

Practice address

4308 Stefanie Dr
Bordentown, NJ 08505

Phone

(508) 296-4301

NPI assigned

Aug 8, 2023

Organization subpart

No

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

Authorized official

Name

Minal Kadam, MA, CCC-SLPNPI 1861912594

Title

Owner, Speech Pathologist

Phone

(508) 296-4301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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.

• Minal Arjun Kadam, MA CCC-SLP

  • Speech-Language Pathologist
  • East Sandwich, MA
  • NPI 1861912594

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1366125254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 ROUTE 33",
            "address_2": "STE 112 UNIT #564",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086911416",
            "telephone_number": "508-296-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 STEFANIE DR",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "08505",
            "telephone_number": "508-296-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN LIFE CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "KADAM",
        "authorized_official_first_name": "MINAL",
        "authorized_official_title_or_position": "OWNER, SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "508-296-4301",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary F. Campagnolo, MD
• Amani Canaan

• Speech-Language Pathologist in Bordentown, NJ
• Providers in Bordentown, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.