Healthcare Provider Details

I. General information

NPI: 1750178802
Provider Name (Legal Business Name): DOUBLE CARE ABA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 SECURITY BLVD STE 100
BALTIMORE MD
21207-5284
US

IV. Provider business mailing address

1274 49TH ST STE 32
BROOKLYN NY
11219-3011
US

V. Phone/Fax

Practice location:
  • Phone: 646-762-1600
  • Fax:
Mailing address:
  • Phone: 973-370-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. SHIA KLEIN
Title or Position: OWNER
Credential:
Phone: 646-762-1600