Active NPI
Lauren Goodwyn, BA
- Behavior Analyst
- Roseland, NJ
National Provider Identifier
1740739846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11622101
- Practice address
- 101 Eisenhower Pkwy Ste 300
Roseland, NJ 07068-1054 - Phone
- (844) 823-7865
- Fax
- (844) 711-9920
- NPI assigned
- Sep 29, 2016
- Last updated
- Sep 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11622101 | NJ | Primary |
Addresses
Primary practice location
101 Eisenhower Pkwy Ste 300
Roseland, NJ 07068-1054
Mailing address
101 Eisenhower Pkwy Ste 300
Roseland, NJ 07068-1054
Phone (844) 823-7865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11622101 | NJ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1740739846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 EISENHOWER PKWY STE 300",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681054",
"telephone_number": "844-823-7865",
"fax_number": "844-711-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 EISENHOWER PKWY STE 300",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681054",
"telephone_number": "844-823-7865",
"fax_number": "844-711-9920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWYN",
"first_name": "LAUREN",
"name_prefix": "Ms.",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-29",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "11622101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.