Provider Demographics
NPI:1346986510
Name:NEW WORLD BEHAVIORAL THERAPY LLC
Entity Type:Organization
Organization Name:NEW WORLD BEHAVIORAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-208-2204
Mailing Address - Street 1:15050 ELDERBERRY LN STE 6-7
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-8504
Mailing Address - Country:US
Mailing Address - Phone:239-208-2204
Mailing Address - Fax:239-437-8099
Practice Address - Street 1:15050 ELDERBERRY LN STE 6-7
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-8504
Practice Address - Country:US
Practice Address - Phone:239-208-2204
Practice Address - Fax:239-437-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty