MERIDIAN BEHAVIORAL HEALTH (NPI# 1770836025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770836025 |
| Entity Type | Organization |
| Organization Name | MERIDIAN BEHAVIORAL HEALTH |
| Other Organization Name | PARK PLACE |
| Practice Address |
1011 Bond St Asbury Park NJ 07712-5939 |
| Practice Telephone | 7328692769 |
| Practice Fax Number | 7328979541 |
| Mailing Telephone | 7328692769 |
| Mailing Fax Number | 7328979541 |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |
| Authorized Official Name | MS. SUSAN M AFFA (SOCIAL WORKER/INTAKE COORDINATOR) |
| Authorized Official Telephone | 7328692769 |
| Authorized Official Credential | LSW |
| Is Organization Subpart | Y |
| Parent Organization Name | MERIDIAN HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
44SL05734800 | NJ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Park Place | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992061311 | Meridian Behavioral Health | Community/Behavioral Health | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2012-04-10 |
| 1679864664 | Meridian Behavioral Health | Health Maintenance Organization | 3329 University Ave Se, Minneapolis, MN 55414-3325 | 2011-04-25 |
| 1548551823 | Meridian Behavioral Health | Counselor | 3329 University Ave Se, Minneapolis, MN 55414-3325 | 2011-04-21 |
| 1104943349 | Meridian Behavioral Health | Substance Abuse Rehabilitation Facility | 550 Main St, New Brighton, MN 55112-3271 | 2007-03-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MERIDIAN BEHAVIORAL HEALTHCARE, INC. | 4300 Sw 13th St, Gainesville, FL 32608-4006 |
| Street Address |
1011 BOND ST |
| City | ASBURY PARK |
| State | NJ |
| Zip Code | 07712-5939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356456297 | Mark Tighe Sullivan | Social Worker | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-08-20 |
| 1386140564 | Christopher Schneider | Counselor | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2018-04-05 |
| 1861932741 | Joanna Weislogel | Counselor | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2017-02-27 |
| 1932536760 | Peter Dougherty | Social Worker | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2013-10-14 |
| 1003243817 | Susan Hatami | Social Worker | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2013-10-11 |
| 1952654972 | Eridian Behavioral Health | Clinic/Center | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2012-10-16 |
| 1023100666 | Peter Bering Wegener | Counselor | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-09-29 |
| 1043302193 | Suzanne Von Bargen | Counselor | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-09-28 |
| 1992897094 | Michael Sean Rafter | Social Worker | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-09-28 |
| 1346332491 | Paula Andria Bucknor | Counselor | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275762 | Derek Du | Physical Therapist | 52 Dune Rd, Ocean Township, NJ 07712 | 2020-08-12 |
| 1295395630 | Lauren Rosenthal | Behavior Technician | 3 Michael Dr, Tinton Falls, NJ 07712 | 2019-06-18 |
| 1649743287 | Zachary Fendrick | Physical Therapist | 1540 West Park Ave Unit #4, Tinton Falls, NJ 07712 | 2019-01-07 |
| 1922597988 | Rosemary E Smentkowski | Nurse Practitioner | 1518 4th Ave, Asbury Park, NJ 07712 | 2018-05-05 |
| 1285131748 | Life Long Health Incorporated | Durable Medical Equipment & Medical Supplies | 606 Bangs Ave 3rd Floor, Unit 327, Asbury Park, NJ 07712 | 2018-04-11 |
| 1174035745 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Wayside Road Apt #213, Wayside Oaks, Tinton Falls, NJ 07712 | 2017-11-03 |
| 1033629159 | The Arc of Monmouth, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Wayside Road Apt 103, Wayside Oaks, Tinton Falls, NJ 07712 | 2017-10-03 |
| 1477063592 | The Arc of Monmouth, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Wayside Road Apt 105, Wayside Oaks, Tinton Falls, NJ 07712 | 2017-10-03 |
| 1750891966 | The Arc of Monmouth, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Wayside Road Apt 107, Wayside Oaks, Tinton Falls, NJ 07712 | 2017-10-03 |
| 1316457526 | The Arc of Monmouth, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Wayside Road Apt 110, Wayside Oaks, Tinton Falls, NJ 07712 | 2017-10-03 |
| Find all providers in zip 07712 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952654972 | Eridian Behavioral Health | Clinic/Center | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2012-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443650 | Quantum Behavioral Health Services LLC | Clinic/Center | 144 Mill St, Toms River, NJ 08757-5156 | 2020-10-08 |
| 1811515042 | Michelle Kerekes Lpc | Clinic/Center | 623 River Rd Ste 1, Fair Haven, NJ 07704-3267 | 2020-07-14 |
| 1962025601 | E Keeney LLC | Clinic/Center | 43 Lakeview Dr, West Milford, NJ 07480-4279 | 2020-05-28 |
| 1407470149 | Schnabolk Lcsw | Clinic/Center | 385 State Route 24 Ste 3m, Chester, NJ 07930-2910 | 2020-05-28 |
| 1871114413 | Odyssey Mental Health and Addiction Center, LLC | Clinic/Center | 35 Journal Sq Ste 629d, Jersey City, NJ 07306-4029 | 2020-05-06 |
| 1992331102 | Nancy Difrancesco LLC | Clinic/Center | 6 White Horse Pike Ste 2a, Haddon Heights, NJ 08035-1246 | 2020-03-19 |
| 1497393789 | Harmony Wellness Counseling Center | Clinic/Center | 190 Nassau St, Princeton, NJ 08542-7012 | 2019-12-17 |
| 1649825944 | Green Oak Professional Health Services | Clinic/Center | 120 Millburn Ave Ste 201, Millburn, NJ 07041-1935 | 2019-08-05 |
| 1083276836 | Hopefull Therapy and Consulting LLC | Clinic/Center | 145 Witherspoon St Ste A4, Princeton, NJ 08542-3228 | 2019-07-02 |
| 1295297372 | Paper and Pencil Bookkeeping | Clinic/Center | 3 Warren Dr, Morristown, NJ 07960-4712 | 2019-04-05 |
| Find all providers with the same taxonomy | ||||
| City | ASBURY PARK |
| Zip Code | 07712 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.