Making a Difference in Teens and Young Adults

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MAKING A DIFFERENCE IN TEENS AND YOUNG ADULTS

Practice address

1035 Sanford Ave
Irvington, NJ 07111-1946

Phone

(973) 652-4199

NPI assigned

Feb 8, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Lashun Goodman, MS, CSW

Title

Ceo

Phone

(973) 652-4199

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1669910725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 SANFORD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111946",
            "telephone_number": "973-652-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 SANFORD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111946",
            "telephone_number": "973-652-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKING A DIFFERENCE IN TEENS AND YOUNG ADULTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "LASHUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-652-4199",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Irvington, NJ
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• Case Management Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.