MEDICARE: LITTLE LEAF ABA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1326900606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE LEAF ABA LLC

Provider Business Mailing Address
First Line	:	525 E COUNTY LINE RD STE 14
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1405
Country	:	US
Telephone Number	:	848-240-2147
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E COUNTY LINE RD STE 14
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1405
Country	:	US
Telephone Number	:	848-240-2147
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHMUEL GOTTLIEB
Credential	:
Telephone Number	:	848-240-2147

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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Directions to “LITTLE LEAF ABA LLC ” Practice Location

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