Kezia Wallerson

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

25 High St Apt C1
Montclair, NJ 07042-2452

Phone

(315) 415-7148

NPI assigned

Feb 12, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Brightpath Support Services LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Montclair, NJ
  • NPI 1851246672

  Health Educator

  NPD Authorized official

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

{
    "created_epoch": "1770854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1831041730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HIGH ST APT C1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422452",
            "telephone_number": "315-415-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HIGH ST APT C1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422452",
            "telephone_number": "315-415-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLERSON",
        "first_name": "KEZIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-12",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reena Vyas-Rana, MA, ED.S, LPC
• Sudha Wadhwani, PSY.D.
• Tallha Waheed, MD
• Susan M Walker, PHD, CGP
• Tamara L Walker
• Jin Wang, MD
• Ying Chun Wang, RN
• Rebecca Ann Ward, LPC
• Stacy L Ward, LCSW
• Susan L. Ward, NBC-HWC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.