Healthcare Provider Details

I. General information

NPI: 1144134966
Provider Name (Legal Business Name): JENNIFER MCCLOSKEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SEIDEL

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 PROSPECT ST
CALDWELL NJ
07006-5537
US

IV. Provider business mailing address

18 PROSPECT ST APT W1
CALDWELL NJ
07006-5537
US

V. Phone/Fax

Practice location:
  • Phone: 201-978-6255
  • Fax:
Mailing address:
  • Phone: 201-978-6255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2852053
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: