Healthcare Provider Details

I. General information

NPI: 1376325605
Provider Name (Legal Business Name): STEP UP BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 BRICK BLVD STE 120
BRICK NJ
08723-7984
US

IV. Provider business mailing address

74 BRICK BLVD STE 120
BRICK NJ
08723-7984
US

V. Phone/Fax

Practice location:
  • Phone: 973-298-0763
  • Fax: 833-538-0904
Mailing address:
  • Phone: 973-298-0763
  • Fax: 833-538-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN VITUG
Title or Position: CO-FOUNDER
Credential: PHD, LBA, BCBA-D
Phone: 908-447-8333