Acm Therapy LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

ACM THERAPY LLC

Practice address

362 Main St
Wyckoff, NJ 07481-1928

Phone

(201) 421-8789

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ailyn Costa-Minch, LCSWNPI 1558703215

Title

Licensed Clinical Social Worker

Phone

(201) 421-8789

Specialties & licenses 2

Addresses

Other names 1

• ACM Therapy LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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.

• Ailyn Costa-Minch, LCSW

  • Clinical Social Worker
  • Hillsdale, NJ
  • NPI 1558703215
  Medicare reassignment Authorized official
• Ernst C Gauderer, MD

  • Psychiatry Physician
  • Fort Lee, NJ
  • NPI 1093760662
  NPD (past)

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1659045896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MARY ANN LN",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813138",
            "telephone_number": "201-421-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 MAIN ST",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811928",
            "telephone_number": "201-421-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "COSTA-MINCH",
        "authorized_official_first_name": "AILYN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "201-421-8789",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACM Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Peter Alicandri, M.S.,P.T.
• Alireza a. Foroushani, PC (Wyckoff Family Chiropractic & Spinal Health Care Center)
• Allergy and Asthma Comprehensive Care

• Adolescent and Children Mental Health Clinic/Center in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.