Aydan Behavioral Health

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

AYDAN BEHAVIORAL HEALTH

Practice address

629 E Wood St Ste 308
Vineland, NJ 08360-3731

Phone

(856) 449-4664

NPI assigned

Jun 20, 2023

Last updated

Jun 20, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

AYDAN GLOBALAs reported in NPPES

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

Authorized official

Name

Mr. Daryl Stafford Jr.

Title

Ceo

Phone

(856) 449-4664

Specialties & licenses 2

Addresses

Other names 1

• n/a Former legal business name

Locations

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1609551233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E WOOD ST STE 308",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603731",
            "telephone_number": "856-449-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E WOOD ST STE 308",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603731",
            "telephone_number": "856-449-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYDAN BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AYDAN GLOBAL",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-449-4664",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.