Provider Demographics
NPI:1700416484
Name:SUMMERFIELD, CATHLEEN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:
Last Name:SUMMERFIELD
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 1:67 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3055
Mailing Address - Country:US
Mailing Address - Phone:856-625-8111
Mailing Address - Fax:
Practice Address - Street 1:500 S BURNT MILL RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2205
Practice Address - Country:US
Practice Address - Phone:888-859-7749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-18-30252103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst