Healthcare Provider Details

I. General information

NPI: 1477482560
Provider Name (Legal Business Name): COLLEEN E. O'DONNELL MSW, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2A 8TH AVE
SEASIDE HEIGHTS NJ
08751-1506
US

IV. Provider business mailing address

3253 MEADOW ST
TOMS RIVER NJ
08753-4831
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-1411
  • Fax: 718-362-1651
Mailing address:
  • Phone: 908-256-6196
  • 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:
Title or Position:
Credential:
Phone: