Organization Active NPI

Proud Moments ABA of New Jersey LLC

  • Behavior Analyst
  • New York, NY
National Provider Identifier
1770190621
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PROUD MOMENTS ABA OF NEW JERSEY LLC
Practice address
350 5TH Ave Ste 6115
New York, NY 10118-6002
Phone
(718) 215-5311
NPI assigned
Sep 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Mr. Mark A Yost Jr.
Title
General Counsel
Phone
(718) 215-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

350 5TH Ave Ste 6115
New York, NY 10118-6002

Mailing address

350 5TH Ave Ste 6115
New York, NY 10118-6002
Phone (718) 215-5311

Other practice location 1

1115 Clifton Ave Ste 202
Clifton, NJ 07013-3650
Phone (718) 215-5311

Other practice location 2

201 Main St
Toms River, NJ 08753-7416
Phone (718) 215-5311

Other practice location 3

118 Talmadge Rd
Edison, NJ 08817-2812
Phone (718) 215-5311

National Provider Directory

National Provider Directory

Locations

118 Talmadge Rd
Edison, NJ 08817
Phone (908) 368-0028

201 Main St
Toms River, NJ 08753
Phone (732) 523-1245

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1770190621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 5TH AVE STE 6115",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101186002",
            "telephone_number": "718-215-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 5TH AVE STE 6115",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101186002",
            "telephone_number": "718-215-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Clifton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070133650",
            "country_code": "US",
            "telephone_number": "718-215-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Main St",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087537416",
            "country_code": "US",
            "telephone_number": "718-215-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Talmadge Rd",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088172812",
            "country_code": "US",
            "telephone_number": "718-215-5311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROUD MOMENTS ABA OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "YOST",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "718-215-5311",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.