Provider Demographics
NPI:1700598299
Name:STROBEL, PHILIP J (BCBA)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:STROBEL
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 LORILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:UNION BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-2914
Mailing Address - Country:US
Mailing Address - Phone:732-328-8764
Mailing Address - Fax:
Practice Address - Street 1:55 NJ-35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-784-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BACB1-22-62584103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst