Provider Demographics
NPI:1114353315
Name:AUTISM BEHAVIOR CONSULTING, LLC
Entity Type:Organization
Organization Name:AUTISM BEHAVIOR CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:631-317-8088
Mailing Address - Street 1:60 BARRETT AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705
Mailing Address - Country:US
Mailing Address - Phone:631-317-8088
Mailing Address - Fax:866-667-2657
Practice Address - Street 1:60 BARRETT AVE
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705
Practice Address - Country:US
Practice Address - Phone:631-317-8088
Practice Address - Fax:866-667-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-05-2325251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health