Individual provider Active NPI

Rachel Kornbluh, BCBA

  • Behavior Analyst
  • Lakewood, NJ
National Provider Identifier
1912879131
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12583475 Issued in NJ
Practice address
945 River Ave
Lakewood, NJ 08701-5659
Phone
(732) 833-3723
NPI assigned
Sep 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12583475 NJ Primary

Addresses

Primary practice location

945 River Ave
Lakewood, NJ 08701-5659

Mailing address

27 Rustic Rd
Lakewood, NJ 08701-4041
Phone (732) 833-3723

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

State licenses

LicenseStateTypeSpecialty
12583475NJMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1912879131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RUSTIC RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014041",
            "telephone_number": "732-833-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015659",
            "telephone_number": "732-833-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLUH",
        "first_name": "RACHEL",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "12583475",
            "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 18, 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.