Provider Demographics
NPI:1184326886
Name:A FRESH START BEHAVIORAL CONSULTING LLC
Entity type:Organization
Organization Name:A FRESH START BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:LEIGHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LORUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:908-309-6446
Mailing Address - Street 1:3306 PINHORN DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3520
Mailing Address - Country:US
Mailing Address - Phone:908-309-6446
Mailing Address - Fax:
Practice Address - Street 1:3306 PINHORN DR
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3520
Practice Address - Country:US
Practice Address - Phone:908-309-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty