Individual provider Active NPI

Paul Howard Ettinger, BCBA

  • Behavior Analyst
  • North Middletown, NJ
National Provider Identifier
1760094072
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-43645 Issued in NJ
Practice address
92 Kentucky Ave
North Middletown, NJ 07748-5346
Phone
(908) 839-8563
Fax
(888) 882-7527
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-20-43645 NJ Primary

Addresses

Primary practice location

92 Kentucky Ave
North Middletown, NJ 07748-5346

Mailing address

363 Peter Forman Dr
Freehold, NJ 07728-9347
Phone (908) 839-8563

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

Practice roles

OrganizationSpecialtyStatusNew patients
Learning and Behavioral Center. LLC Behavior Analyst CurrentSince Apr 6, 2025 Accepting new patients
Scottsdale Pediatric Behavioral Services PLLC Behavior Analyst Past Accepting new patients

Locations

5554 Reseda Blvd
Tarzana, CA 91356
Phone (818) 698-9507

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1760094072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 PETER FORMAN DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289347",
            "telephone_number": "908-839-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 KENTUCKY AVE",
            "city": "NORTH MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077485346",
            "telephone_number": "908-839-8563",
            "fax_number": "888-882-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "PAUL",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-20-43645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Middletown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.