MEDICARE: SHALOM ABA SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1447056148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHALOM ABA SERVICES

Provider Business Mailing Address
First Line	:	511 ANTHWYN RD
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 ANTHWYN RD
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1328
Country	:	US
Telephone Number	:	610-348-2852
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MENDEL COHEN
Credential	:
Telephone Number	:	610-348-2852

Provider Enumeration Date	:	02/22/2025
Last Update Date	:	02/24/2025

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Directions to “SHALOM ABA SERVICES ” Practice Location

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