Supportive Licensed Behavior Analyst PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SUPPORTIVE LICENSED BEHAVIOR ANALYST PLLC

Practice address

667 Rodrigues LN
Jackson, NJ 08527-4818

Phone

(917) 831-9691

NPI assigned

Jun 17, 2025

Organization subpart

No

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

Authorized official

Name

Yosef Toledano

Title

Ceo

Phone

(917) 831-9691

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1871489674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 N 52ND AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213912",
            "telephone_number": "917-831-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 RODRIGUES LN",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274818",
            "telephone_number": "917-831-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE LICENSED BEHAVIOR ANALYST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "TOLEDANO",
        "authorized_official_first_name": "YOSEF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-831-9691"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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