Healthcare Provider Details

I. General information

NPI: 1861316176
Provider Name (Legal Business Name): KELLI THOMAS MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 LAKEHURST RD
TOMS RIVER NJ
08755-6380
US

IV. Provider business mailing address

7 LISA ROBYN CIR APT 209
LAKEWOOD NJ
08701-7013
US

V. Phone/Fax

Practice location:
  • Phone: 732-719-4752
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: