Provider Demographics
NPI:1275257073
Name:PROGRESSIVE BEHAVIOR THERAPY INC
Entity Type:Organization
Organization Name:PROGRESSIVE BEHAVIOR THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYCHKO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-718-9599
Mailing Address - Street 1:8960 SW HIGHWAY 200 STE 2
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-1700
Mailing Address - Country:US
Mailing Address - Phone:786-718-9599
Mailing Address - Fax:877-388-1240
Practice Address - Street 1:8960 SW HIGHWAY 200 STE 2
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-1700
Practice Address - Country:US
Practice Address - Phone:786-718-9599
Practice Address - Fax:877-388-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty