Xanadu Behavior Therapy
Organization Active NPI Behavior Analyst · Forked River, NJ
NPI 1992933634 · NPPES record last updated Feb 25, 2013
Key facts
- NPI
- 1992933634
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 0-06-2178 (NJ)
- Legal business name
- XANADU BEHAVIOR THERAPY
- Practice address
- 615 Lacey Rd
Suite 3
Forked River, NJ 08731-2200 - Phone
- (609) 242-3322
- Fax
- (609) 242-3333
- NPI assigned
- Jul 1, 2009
- Organization subpart
- No
Authorized official
- Name
- Ms. Stacie Groeling
- Title
- Executive Director
- Phone
- (609) 242-3322
Practitioners 13
-
Rachael M Ferrara, M.S.
-
Amy Hogan, BCBA
-
Stephanie Makow, LSW
-
Cynthia Lynn Policastro-Smith, MA, BCBA
-
Amanda Blair Mokracek, M.A.
-
Lauren Pizzulli, LCSW
National Provider Directory
Locations
615 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-3322
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | 0-06-2178 | NJ | Yes |
| Social Worker |
104100000X | 44SL04976200 | NJ |
Addresses
Primary practice location
615 Lacey Rd
Suite 3
Forked River, NJ 08731-2200
Mailing address
615 Lacey Rd
Suite 3
Forked River, NJ 08731-2200
Phone (609) 242-3322
Other providers in Forked River, NJ
- Sara Beth Wilbert
- William K. Power, MD, PA
- George Williams
- Erin Kathleen Wimer
- Sarah Winton
- Yassin Pediatrics
- Mahmoud Yassin
- Daniel Yoo
- Hassan Younas
- Young Minds Pediatrics LLC
All providers in Forked River, NJ · Behavior Analyst in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.