Provider Demographics
NPI:1740974567
Name:SIMEONE, ADELYN N (BCBA)
Entity type:Individual
Prefix:
First Name:ADELYN
Middle Name:N
Last Name:SIMEONE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 E HOLLY AVE APT 43
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-1709
Mailing Address - Country:US
Mailing Address - Phone:609-680-8630
Mailing Address - Fax:
Practice Address - Street 1:8 CHERRYWOOD DR
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-5612
Practice Address - Country:US
Practice Address - Phone:856-566-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-22-57733103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst