Healthcare Provider Details

I. General information

NPI: 1972916815
Provider Name (Legal Business Name): JMK BEHAVIOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 11/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MILLTOWN ROAD SUITE 11
WILMINGTON DE
19808
US

IV. Provider business mailing address

1601 MILLTOWN ROAD SUITE 11
WILMINGTON DE
19808
US

V. Phone/Fax

Practice location:
  • Phone: 302-981-9003
  • Fax:
Mailing address:
  • Phone: 302-981-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JODI MICHELLE KARABIN
Title or Position: PRESIDENT
Credential: LPC, NCC, CADC
Phone: 302-981-9003