Active NPI
Tara Mintz-Kilcrease
- Behavior Analyst
- Lakewood, NJ
National Provider Identifier
1912464736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-18-33753
- Practice address
- 2 Esther CT
Lakewood, NJ 08701-2946 - Phone
- (732) 523-1245
- Fax
- (732) 400-9170
- NPI assigned
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-18-33753 | NJ | Primary |
Addresses
Primary practice location
2 Esther CT
Lakewood, NJ 08701-2946
Mailing address
2 Esther CT
Lakewood, NJ 08701-2946
Phone (732) 523-1245
Other practice location 1
910 E Main St
Lincolnton, NC 28092-3449
Phone (704) 748-0616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehab LLC | Behavior Analyst | Past | Accepting new patients |
| Complete Rehabilitation and Sports Physical Therapy, PC | Past | Accepting new patients | |
| Build N Care Therapy | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Behavior Analyst
- Lakewood, NJ
- NPI 1073859815
-
- Physical Therapist
- Ronkonkoma, NY
- NPI 1811097306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1912464736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 ESTHER CT",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087012946",
"telephone_number": "732-523-1245",
"fax_number": "732-400-9170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 ESTHER CT",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087012946",
"telephone_number": "732-523-1245",
"fax_number": "732-400-9170"
}
],
"practiceLocations": [
{
"address_1": "910 E Main St",
"address_purpose": "LOCATION",
"city": "Lincolnton",
"state": "NC",
"postal_code": "280923449",
"country_code": "US",
"telephone_number": "704-748-0616",
"fax_number": "704-240-9980",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MINTZ-KILCREASE",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-28",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "1-18-33753",
"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 Sep 9, 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.