Provider Demographics
NPI:1477147841
Name:MIGHTY MINDS NJ LLC
Entity Type:Organization
Organization Name:MIGHTY MINDS NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLCIK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:908-577-1194
Mailing Address - Street 1:220 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2965
Mailing Address - Country:US
Mailing Address - Phone:908-577-1194
Mailing Address - Fax:
Practice Address - Street 1:220 HIGH ST
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2965
Practice Address - Country:US
Practice Address - Phone:908-577-1194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty