Provider Demographics
NPI:1689204745
Name:STRATEGIC THERAPY AUTISM SERVICES
Entity Type:Organization
Organization Name:STRATEGIC THERAPY AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:732-966-3878
Mailing Address - Street 1:392 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9718
Mailing Address - Country:US
Mailing Address - Phone:609-779-2280
Mailing Address - Fax:
Practice Address - Street 1:392 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08620-9718
Practice Address - Country:US
Practice Address - Phone:609-779-2280
Practice Address - Fax:609-316-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14407273OtherCAQH