Provider Demographics
NPI:1487311643
Name:SHLIMAK, HAVA (BS, BA, BCBA)
Entity type:Individual
Prefix:
First Name:HAVA
Middle Name:
Last Name:SHLIMAK
Suffix:
Gender:F
Credentials:BS, BA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 PINEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2018
Mailing Address - Country:US
Mailing Address - Phone:404-808-9777
Mailing Address - Fax:
Practice Address - Street 1:1 DIAMOND CAUSEWAY
Practice Address - Street 2:SUITE 21 - 121
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-7417
Practice Address - Country:US
Practice Address - Phone:912-434-4343
Practice Address - Fax:912-452-9600
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-23-65241103K00000X
GARBT-21-188282103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-23-65241OtherBACB