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General NPI Number Information
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NPI Number | 1487380242
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Entity Type | Organization
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Legal Business Name | AG BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 725 RIVER ROAD SUITE 32 #313
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-1502
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Country | US
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Telephone | 201-873-8611
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Fax | 201-945-0562
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Provider Business Mailing Address
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Address Line | 725 RIVER ROAD SUITE 32 #313
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-1502
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Country | US
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Telephone | 201-873-8611
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Fax | 201-945-0562
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA E GONZALEZ
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Credential | BCBA
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Telephone | 201-873-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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