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NPI 1740105014

NPI 1740105014 : BEAMING KIDS VA LLC : LAKEWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1740105014
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    Entity Type          |    Organization 
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    Legal Business Name  |    BEAMING KIDS VA LLC 
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Dates
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    Enumeration Date     |    08/13/2026
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    Last Update Date     |    08/13/2026
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Provider Practice Location Address
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    Address Line         |    74 CARASALJO DR, 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701
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    Country              |    US
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    Telephone            |    410-401-0042
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11815 FOUNTAIN WAY STE 300 
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    City                 |    NEWPORT NEWS
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    State                |    VA
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    Zip                  |    23606-4448
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    Country              |    US
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    Telephone            |    410-401-0042
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    Fax                  |    410-216-1069
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     AVRAHAM  YORMARK 
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    Credential           |    
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    Telephone            |    410-401-0042
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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        |    106E00000X
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    Taxonomy Name        |    Assistant Behavior Analyst
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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