Healthcare Provider Details

I. General information

NPI: 1013548270
Provider Name (Legal Business Name): ESSENTIAL BEGINNINGS BEHAVIOR AND LEARNING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 E MOUNT VERNON ST
SMYRNA DE
19977-1483
US

IV. Provider business mailing address

389 DELAWARE RIVER DR
CLAYTON DE
19938-3963
US

V. Phone/Fax

Practice location:
  • Phone: 302-278-0052
  • Fax:
Mailing address:
  • Phone: 609-721-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LASANDRA STAMPER
Title or Position: BCBA
Credential: BCBA
Phone: 609-721-2724