Lisa Ciniello
Individual provider Active NPI Behavior Analyst · Forked River, NJ
NPI 1669807665 · NPPES record last updated Sep 9, 2013
Key facts
- NPI
- 1669807665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 878456 (NJ)
- Practice address
- 615 Lacey Rd
Suite 3
Forked River, NJ 08731-2200 - Phone
- (609) 242-3322
- NPI assigned
- Sep 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 878456 | NJ | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Xanadu Behavior Therapy | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 878456 | NJ | Yes |
Addresses
Primary practice location
615 Lacey Rd
Suite 3
Forked River, NJ 08731-2200
Mailing address
210 North Park Dr
Woodbridge, NJ 07095
Phone (908) 930-6890
NPI Registry JSON
{
"created_epoch": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1669807665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 NORTH PARK DR",
"city": "WOODBRIDGE",
"state": "NJ",
"postal_code": "07095",
"telephone_number": "908-930-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 LACEY RD",
"address_2": "SUITE 3",
"city": "FORKED RIVER",
"state": "NJ",
"postal_code": "087312200",
"telephone_number": "609-242-3322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CINIELLO",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-09",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "878456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forked River, NJ
- Cavalier Senior Care
- Central Ocean County Diagnostic Imaging Center, LLC
- Patricia Ann Christensen
- Joseph Ciaburri
- Samantha Cimirro
- Kathleen Clayton
- Clifford Barneman, Psy D, LLC
- Coastal Pediatric Orthopedics
- Lauren Colella
- Community Options Enterprises, Inc.
All providers in Forked River, NJ · Behavior Analyst in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.