Provider Demographics
NPI:1427327022
Name:JAMES, BEVIN L (BCBA)
Entity type:Individual
Prefix:MRS
First Name:BEVIN
Middle Name:L
Last Name:JAMES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:BEVIN
Other - Middle Name:L
Other - Last Name:TUZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBS
Mailing Address - Street 1:11 MORTIMER PL
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941-1106
Mailing Address - Country:US
Mailing Address - Phone:516-972-7051
Mailing Address - Fax:631-270-4378
Practice Address - Street 1:11 MORTIMER PL
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:NY
Practice Address - Zip Code:11941-1106
Practice Address - Country:US
Practice Address - Phone:516-972-7051
Practice Address - Fax:631-270-4378
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-09-5684103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst