Provider Demographics
NPI:1164882502
Name:NEW DIRECTION ABA
Entity Type:Organization
Organization Name:NEW DIRECTION ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:201-805-8070
Mailing Address - Street 1:430 RIDGE RD
Mailing Address - Street 2:A-21
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-2428
Mailing Address - Country:US
Mailing Address - Phone:201-805-8070
Mailing Address - Fax:
Practice Address - Street 1:430 RIDGE RD
Practice Address - Street 2:A-21
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-2428
Practice Address - Country:US
Practice Address - Phone:201-805-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-27
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-14-17752251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health