Healthcare Provider Details
I. General information
NPI: 1043145550
Provider Name (Legal Business Name): STEP UP BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2026
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
- Phone: 973-298-0763
- Fax: 833-538-0904
- Phone: 973-298-0763
- Fax: 833-538-0904
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
VITUG
Title or Position: OWNER
Credential: PHD, LBA, BCBA-D
Phone: 973-298-0763