Healthcare Provider Details

I. General information

NPI: 1235897562
Provider Name (Legal Business Name): CONNECT N CARE ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6634 OLD STATESVILLE RD
CHARLOTTE NC
28269-6768
US

IV. Provider business mailing address

1072 MADISON AVE STE 625
LAKEWOOD NJ
08701-2650
US

V. Phone/Fax

Practice location:
  • Phone: 877-262-2221
  • Fax: 877-745-4345
Mailing address:
  • Phone: 877-262-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. F ORZEL
Title or Position: CHIEF CLINICAL DIRECTOR
Credential: BCBA
Phone: 877-262-2221