Provider Demographics
NPI:1609464577
Name:WERZBERGER, TZIPPI (BCBA)
Entity Type:Individual
Prefix:
First Name:TZIPPI
Middle Name:
Last Name:WERZBERGER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAJESTIC WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5018
Mailing Address - Country:US
Mailing Address - Phone:732-998-5606
Mailing Address - Fax:
Practice Address - Street 1:80 HILLSIDE BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3798
Practice Address - Country:US
Practice Address - Phone:732-534-7325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 174400000X
NJ1-20-41137103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174400000XOther Service ProvidersSpecialist