Healthcare Provider Details

I. General information

NPI: 1417885120
Provider Name (Legal Business Name): BEHAVIOR EVOLVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 TARA DR
WILLIAMSTOWN NJ
08094-3590
US

IV. Provider business mailing address

1136 TARA DR
WILLIAMSTOWN NJ
08094-3590
US

V. Phone/Fax

Practice location:
  • Phone: 609-922-4749
  • Fax:
Mailing address:
  • Phone: 609-922-4749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MICHAEL MCDANIELS JR.
Title or Position: CEO
Credential: MA, BCBA LBS
Phone: 609-922-4749