Provider Demographics
NPI:1528379013
Name:BEAUTIFUL MINDS OF PRINCETON
Entity Type:Organization
Organization Name:BEAUTIFUL MINDS OF PRINCETON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:UMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MED BCBA
Authorized Official - Phone:1800-675-2709
Mailing Address - Street 1:PO BOX 1143
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-1143
Mailing Address - Country:US
Mailing Address - Phone:800-675-2709
Mailing Address - Fax:800-675-2709
Practice Address - Street 1:118 KESWICK AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-2836
Practice Address - Country:US
Practice Address - Phone:800-675-2709
Practice Address - Fax:800-675-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-08-4599103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty