Provider Demographics
NPI:1841596988
Name:NASTASKIN, INGA (LMSW, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:INGA
Middle Name:
Last Name:NASTASKIN
Suffix:
Gender:F
Credentials:LMSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 PAWNEE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-3007
Mailing Address - Country:US
Mailing Address - Phone:917-488-3471
Mailing Address - Fax:
Practice Address - Street 1:49 PAWNEE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-3007
Practice Address - Country:US
Practice Address - Phone:917-488-3471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-15-20816103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst