Healthcare Provider Details

I. General information

NPI: 1265224943
Provider Name (Legal Business Name): BEAMING KIDS ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 CARASALJO DR
LAKEWOOD NJ
08701-2307
US

IV. Provider business mailing address

521 REYNOLDS AVE
TOMS RIVER NJ
08755-1469
US

V. Phone/Fax

Practice location:
  • Phone: 410-401-0042
  • Fax: 410-216-1069
Mailing address:
  • Phone: 848-525-2305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AVRAHAM YORMARK
Title or Position: DIRECTOR
Credential:
Phone: 848-525-2305