Provider Demographics
NPI:1255923496
Name:NEGRON, JOSE ANIBAL (MSW, LBS)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ANIBAL
Last Name:NEGRON
Suffix:
Gender:M
Credentials:MSW, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 COURT ST # 301
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3924
Mailing Address - Country:US
Mailing Address - Phone:610-750-9346
Mailing Address - Fax:
Practice Address - Street 1:237 COURT ST # 301
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3924
Practice Address - Country:US
Practice Address - Phone:610-750-9346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004183103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty