Healthcare Provider Details
I. General information
NPI: 1447144282
Provider Name (Legal Business Name): ACHIEVE BEYOND LICENSED BEHAVIOR ANALYSTS OF NJ PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
424 CENTRAL AVE UNIT 2
WESTFIELD NJ
07090
US
IV. Provider business mailing address
225 BROADHOLLOW RD STE 402
MELVILLE NY
11747-4899
US
V. Phone/Fax
- Phone: 631-385-7780
- Fax:
- Phone: 631-385-7780
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIA
MATUZA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LBA, BCBA
Phone: 631-385-7780