Leading Youth Through Experience, LLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Legal business name

LEADING YOUTH THROUGH EXPERIENCE, LLC

Practice address

2 Arrowhead CT
Freehold, NJ 07728-9577

Phone

(732) 458-3201

Fax

(732) 458-3269

NPI assigned

Apr 19, 2018

Organization subpart

No

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

Authorized official

Name

Jason Mark Rosenberg

Title

Owner/Executive Director

Phone

(732) 458-3201

Specialties & licenses 7

Addresses

Other identifiers 1

Tax ID family

Leading Youth Through Experience LLC2 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.

• Leading Youth Through Experience, LLC

  • Community/Behavioral Health Agency
  • Brick, NJ
  • NPI 1225240633
  NPD tax ID

Practitioners 1

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

• Lauren Tenenbaum, LCSW

  • Clinical Social Worker
  • Port Monmouth, NJ
  • NPI 1831663756
  NPD (past)

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1417444076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ARROWHEAD CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289577",
            "telephone_number": "732-458-3201",
            "fax_number": "732-458-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ARROWHEAD CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289577",
            "telephone_number": "732-458-3201",
            "fax_number": "732-458-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING YOUTH THROUGH EXPERIENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-458-3201"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225240633",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan Lau, RPH
• Lauren Ruggiero, LLC
• Linda J Law
• Jennifer Lorraine Lawrence, LPC, LPAT, ATR-BC
• Danielle L Lazzaro, LPC
• David A Lederman, DMD
• Brigit Lee
• David K Lee, MD
• Jae Young Lee, M.D., PH.D.
• Michael A Lee, PTA

• Intellectual & Developmental Disabilities Psychologist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Intellectual & Developmental Disabilities Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.