Provider Demographics
NPI:1346764818
Name:ABA BY THE SEA, LLC
Entity Type:Organization
Organization Name:ABA BY THE SEA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GLASSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:732-604-4762
Mailing Address - Street 1:397 N LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1519
Mailing Address - Country:US
Mailing Address - Phone:732-604-4762
Mailing Address - Fax:
Practice Address - Street 1:397 N LAKE DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1519
Practice Address - Country:US
Practice Address - Phone:732-604-4762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty