Provider Demographics
NPI:1770108722
Name:HEIMAN, CARLI M (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:CARLI
Middle Name:M
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 COLUMBUS AVE APT 10R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6480
Mailing Address - Country:US
Mailing Address - Phone:201-783-9360
Mailing Address - Fax:
Practice Address - Street 1:750 COLUMBUS AVE APT 10R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6480
Practice Address - Country:US
Practice Address - Phone:201-783-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-37968103K00000X
NY002278-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst