Provider Demographics
NPI:1831611672
Name:CHARNAS, SIMCHA (MA BCBA)
Entity type:Individual
Prefix:
First Name:SIMCHA
Middle Name:
Last Name:CHARNAS
Suffix:
Gender:M
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4831
Mailing Address - Country:US
Mailing Address - Phone:732-806-0802
Mailing Address - Fax:
Practice Address - Street 1:248 PINE ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4831
Practice Address - Country:US
Practice Address - Phone:732-806-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-26225103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst