Provider Demographics
NPI:1225724925
Name:BRICK BY BRICK THERAPY LLC
Entity Type:Organization
Organization Name:BRICK BY BRICK THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:646-894-4192
Mailing Address - Street 1:231 N WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1736
Mailing Address - Country:US
Mailing Address - Phone:646-894-4192
Mailing Address - Fax:
Practice Address - Street 1:231 N WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1736
Practice Address - Country:US
Practice Address - Phone:646-894-4192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty