NPIMap

Organization Active NPI

Minding Miracles

  • Behavior Analyst
  • Port Monmouth, NJ
National Provider Identifier
1437669884
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-19229 Issued in NJ
Legal business name
MINDING MIRACLES
Practice address
405 Highway 36
Port Monmouth, NJ 07758-1323
Phone
(732) 291-0810
Fax
(732) 291-0502
NPI assigned
Oct 11, 2017
Last updated
Apr 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Authorized official

Name
Kathleen Demarco, BCBA
Title
President
Phone
(848) 757-2123

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X
Respite Care 385H00000X
Behavior Analyst 103K00000X 1-15-19229 NJ Primary

Addresses

Primary practice location

405 Highway 36
Port Monmouth, NJ 07758-1323

Mailing address

204 Wilson Ave
Port Monmouth, NJ 07758-1228
Phone (848) 757-2123

Other identifiers 1

IdentifierTypeStateIssuer
0490113MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Minding Miracles6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713657600000",
    "number": "1437669884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WILSON AVE",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581228",
            "telephone_number": "848-757-2123",
            "fax_number": "732-769-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 36",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581323",
            "telephone_number": "732-291-0810",
            "fax_number": "732-291-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDING MIRACLES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "848-757-2123",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-15-19229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490113",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Monmouth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2024; 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.