NPIMap

Organization Active NPI

Mastermind Behavior Services

  • Behavior Analyst
  • Lakewood, NJ
National Provider Identifier
1891148227
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0450090137 Issued in NJ
Legal business name
MASTERMIND BEHAVIOR SERVICES
Practice address
204 Hadassah LN
Lakewood, NJ 08701-5562
Phone
(732) 367-0781
Fax
(732) 367-0781
NPI assigned
Jul 20, 2016
Last updated
Jul 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Mrs. Raizy Perlstein, BCBA
Title
Owner
Phone
(732) 367-0781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 0450090137 NJ Primary

Addresses

Primary practice location

204 Hadassah LN
Lakewood, NJ 08701-5562

Mailing address

204 Hadassah LN
Lakewood, NJ 08701-5562
Phone (732) 367-0781

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1891148227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HADASSAH LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015562",
            "telephone_number": "732-367-0781",
            "fax_number": "732-367-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HADASSAH LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015562",
            "telephone_number": "732-367-0781",
            "fax_number": "732-367-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTERMIND BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "PERLSTEIN",
        "authorized_official_first_name": "RAIZY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-367-0781",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "0450090137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.