Individualized Supports

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

INDIVIDUALIZED SUPPORTS

Practice address

666 Paxson Ave
Hamilton, NJ 08619-1143

Phone

(973) 647-4980

NPI assigned

Nov 22, 2023

Organization subpart

No

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

Authorized official

Name

Samantha Cooper, BCBANPI 1447925565

Title

Owner

Phone

(973) 647-4980

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Cooper, MS, BCBA

  • Behavior Analyst
  • Edison, NJ
  • NPI 1447925565
  NPD Authorized official

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1912772633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 PAXSON AVE",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191143",
            "telephone_number": "973-647-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 PAXSON AVE",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191143",
            "telephone_number": "973-647-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUALIZED SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-647-4980",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Hamilton, NJ
• Providers in Hamilton, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.