=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003069329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE UNCOMMON THREAD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2008
-----------------------------------------------------
Last Update Date | 09/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1071 VALLEY RD
-----------------------------------------------------
City | STIRLING
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07980-1523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-604-4500
-----------------------------------------------------
Fax | 908-604-4505
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1071 VALLEY RD
-----------------------------------------------------
City | STIRLING
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07980-1523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-604-4500
-----------------------------------------------------
Fax | 908-604-4505
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FINANCE COORDINATOR
-----------------------------------------------------
Name | AMY MEDINA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-604-4500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 302F00000X
-----------------------------------------------------
Taxonomy Name | Exclusive Provider Organization
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------