BACK ON TRACK COUNSELING LLC (NPI# 1194379255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194379255 |
| Entity Type | Organization |
| Organization Name | BACK ON TRACK COUNSELING LLC |
| Practice Address |
19 Orange Pl Irvington NJ 07111-2019 |
| Practice Telephone | 9734748441 |
| Mailing Telephone | 9734748441 |
| Enumeration Date | 2019-07-27 |
| Last Update Date | 2019-07-27 |
| Authorized Official Name | MR. MUSTAFA SHAKIR ABDUS-SALAAM (CEO) |
| Authorized Official Telephone | 8622175144 |
| Authorized Official Credential | MHS-C,LPC, LCADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BACK ON TRACK COUNSELING LLC | 27714 78th Ave Nw, Stanwood, WA 98292-4727 |
| Colorado Business Entities | Back on Track Counseling LLC | 9726 Townsville Cir, Highlands Ranch, CO 80130 |
| Street Address |
19 ORANGE PL |
| City | IRVINGTON |
| State | NJ |
| Zip Code | 07111-2019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447730411 | Mustafa Shakir Abdus-salaam | Counselor | 19 Orange Pl, Irvington, NJ 07111-2019 | 2018-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548871163 | Le Choix Home Care LLC | Home Health | 1395-1399 Clinton Ave, Irvington, NJ 07111 | 2020-08-17 |
| 1528532447 | All America Medical Day Care | Custodial Care Facility | 141 Coit St, Irvington, NJ 07111 | 2019-01-14 |
| 1548737240 | Irvington Adult Day Care Center | Clinic/Center | 62-70 Howard Street, Irvington, NJ 07111 | 2018-10-31 |
| 1245754084 | Soul House Cruber Wellness Center | Counselor | 1144 Clinton Avenue, Irvington, NJ 07111 | 2017-08-02 |
| 1689194094 | Anthony Ijehsedeh | Nurse Practitioner | 12 Krotik Place, Irvington, NJ 07111 | 2017-06-27 |
| 1467993246 | Sia Kendema | Respite Care | 102 Paine Avenue, Irvington, NJ 07111 | 2017-03-14 |
| 1316482078 | Walgreen Co | Pharmacy | 810 Springfield Ave, Irvington, NJ 07111 | 2017-01-04 |
| 1679023915 | Lyons Pharmacy | Pharmacy | 471 Lyons Ave #79, Irvington, NJ 07111 | 2016-10-11 |
| 1952759276 | Sabreehouse | Community/Behavioral Health | 74 Welland Avenue, Irvington, NJ 07111 | 2016-05-26 |
| 1447624184 | Marius Nzo Yonkeu | Pharmacist | 19 Bruen Ave Apt C1, Irvington, NJ 07111 | 2015-11-18 |
| Find all providers in zip 07111 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184372 | Joseph M Sampson | Counselor | 32 Harrison Pl, Irvington, NJ 07111-4304 | 2020-01-29 |
| 1407240922 | Vera Carpenter | Counselor | 1344 Springfield Ave, Irvington, NJ 07111-1362 | 2015-03-23 |
| 1508274911 | Brittany Haberman | Counselor | 12701 Padgett Switch Rd, Irvington, AL 36544-4011 | 2014-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568203 | Shannon Smith | Counselor | 99 Huckleberry Ct, Three Bridges, NJ 08887-2109 | 2020-11-08 |
| 1720689516 | Janice Belarmino | Counselor | 22 5th Ave, Avenel, NJ 07001 | 2020-11-06 |
| 1457951048 | James Peter Gallagher | Counselor | 3005 Vroom Dr, Bridgewater, NJ 08807-7037 | 2020-11-01 |
| 1669072542 | Lauren Marie Didonato | Counselor | 1533 Hillside Dr, Cherry Hill, NJ 08003-3536 | 2020-10-29 |
| 1699375840 | Letitia Schuman | Counselor | 217 N Locust Ave, Marlton, NJ 08053-1787 | 2020-10-27 |
| 1629677703 | Shoshana Yaffa Hochstadter | Counselor | 123 Edgewood Ave, Clifton, NJ 07012-1514 | 2020-10-20 |
| 1992304356 | Virginia Haase | Counselor | 777 Grove Ave, Edison, NJ 08820-2770 | 2020-10-18 |
| 1205434214 | Margaret Sunny Sullivan-fullerton | Counselor | 63 Rockwood Dr, Rockaway, NJ 07866-4152 | 2020-10-12 |
| 1699373860 | William Defilippo | Counselor | 22 Andrea Dr, North Caldwell, NJ 07006-4727 | 2020-10-11 |
| 1093313389 | Gina Kuijlaars | Counselor | 1390 Valley Rd Ste 2c, Stirling, NJ 07980-1346 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BACK ON TRACK COUNSELING LLC.
| 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.