Healthcare Provider Details
I. General information
NPI: 1558288696
Provider Name (Legal Business Name): PROGRESS ABA INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 PROSPECT AVE
HACKENSACK NJ
07601-1909
US
IV. Provider business mailing address
20-18 HALSTEAD TER
FAIR LAWN NJ
07410-4539
US
V. Phone/Fax
- Phone: 914-490-3891
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KOKO
ABSOLAM
Title or Position: CLINICAL DIRECTOR/LEAD BCBA
Credential: BCBA, MS, LBA
Phone: 702-591-5696