Healthcare Provider Details

I. General information

NPI: 1326504838
Provider Name (Legal Business Name): CS ABA CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 CHESTNUT ST
STANHOPE NJ
07874-3454
US

IV. Provider business mailing address

43 CHESTNUT ST
STANHOPE NJ
07874-3454
US

V. Phone/Fax

Practice location:
  • Phone: 201-736-1633
  • Fax:
Mailing address:
  • Phone: 201-736-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CARMELLINA STETSON
Title or Position: OWNER
Credential: BCBA
Phone: 201-736-1633