Collaborative Support Program of New Jersey, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COLLABORATIVE SUPPORT PROGRAM OF NEW JERSEY, INC

Practice address

11 Spring St
Freehold, NJ 07728-1843

Phone

(732) 780-1175

Fax

(732) 780-8977

NPI assigned

Oct 18, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Steven M. Blackburn

Title

Chief Financial Officer

Phone

(732) 414-0081

Specialties & licenses 1

Addresses

Tax ID family

Collaborative Support Program of New Jersey Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Collaborative Support Program of New Jersey, Inc

  • Case Management Agency
  • Freehold, NJ
  • NPI 1912892852
  NPD tax ID

Locations

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1871314385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SPRING ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281843",
            "telephone_number": "732-780-1175",
            "fax_number": "732-780-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SPRING ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281843",
            "telephone_number": "732-780-1175",
            "fax_number": "732-780-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE SUPPORT PROGRAM OF NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "732-414-0081",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Grace Cohen, LCSW
• Brian K Cohen, MD
• Karen Cohen, MPT
• Meagan R Coleman, DPM
• Collaborative Support Program of New Jersey, Inc
• Collaborative Support Program of New Jersey, Inc
• Megan Colligan
• Shari Collins, D.C.
• Tiffany L Colon, RBT
• Community Care Inc

• Community/Behavioral Health Agency in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.