Provider Demographics
NPI:1720498082
Name:MCKIM, JUNE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:MCKIM
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2307
Mailing Address - Country:US
Mailing Address - Phone:732-749-0398
Mailing Address - Fax:
Practice Address - Street 1:905 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2307
Practice Address - Country:US
Practice Address - Phone:732-749-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-13-14407103K00000X
NY000199103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst