NPIMap

Organization Active NPI

Theracare Managed Services, LLC

  • Behavior Analyst
  • Clark, NJ
National Provider Identifier
1922628155
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
THERACARE MANAGED SERVICES, LLC
Practice address
67 Walnut Ave
Suite 105
Clark, NJ 07066-1640
Phone
(855) 681-8555
Fax
(914) 560-2102
NPI assigned
Apr 17, 2020
Organization subpart
Yes
Parent organization
THERACARE OF NEW YORK, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Authorized official

Name
Ms. Mary Caroline McCarthy
Title
Director of Contract Development
Phone
(212) 564-2350

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

67 Walnut Ave
Suite 105
Clark, NJ 07066-1640

Mailing address

1133 Westchester Ave.
N230
White Plains, NY 10604-3516
Phone (212) 564-2350

Other names 1

  • ABA Provider Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
ABA Provider Services2 organizations share this tax ID, including this one
Part of
Theracare of New York Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

67 Walnut Ave
Ste 105
Clark, NJ 07066
Phone (732) 382-1700

1133 Westchester Ave
Ste N-230
White Plains, NY 10604
Phone (914) 576-5292

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1922628155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 WESTCHESTER AVE.",
            "address_2": "N230",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043516",
            "telephone_number": "212-564-2350",
            "fax_number": "212-564-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE",
            "address_2": "SUITE 105",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "855-681-8555",
            "fax_number": "914-560-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERACARE MANAGED SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THERACARE OF NEW YORK, INC.",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CAROLINE",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACT DEVELOPMENT",
        "authorized_official_telephone_number": "212-564-2350",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABA Provider Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.