Provider Demographics
NPI:1225793441
Name:APPLIED BEHAVIOR ANALYSIS SERVICES LICENSED BEHAVIOR ANALYST P.L.L.C.
Entity Type:Organization
Organization Name:APPLIED BEHAVIOR ANALYSIS SERVICES LICENSED BEHAVIOR ANALYST P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA
Authorized Official - Phone:347-397-1251
Mailing Address - Street 1:16 MARINER WAY
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 MARINER WAY
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1616
Practice Address - Country:US
Practice Address - Phone:347-397-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty