Provider Demographics
NPI:1851007397
Name:SJ BEHAVIOR SERVICES LLC
Entity type:Organization
Organization Name:SJ BEHAVIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:RIVELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ABA BCBA
Authorized Official - Phone:856-718-0984
Mailing Address - Street 1:215 LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1139
Mailing Address - Country:US
Mailing Address - Phone:856-718-0984
Mailing Address - Fax:
Practice Address - Street 1:215 LANDIS AVE
Practice Address - Street 2:
Practice Address - City:OAKLYN
Practice Address - State:NJ
Practice Address - Zip Code:08107-1139
Practice Address - Country:US
Practice Address - Phone:856-718-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty