Provider Demographics
NPI:1417483231
Name:MAC BEHAVIOR SOLUTIONS
Entity Type:Organization
Organization Name:MAC BEHAVIOR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSED, BCBA, LBA
Authorized Official - Phone:516-236-7475
Mailing Address - Street 1:17 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1705
Mailing Address - Country:US
Mailing Address - Phone:516-236-7475
Mailing Address - Fax:
Practice Address - Street 1:17 ADAMS ST
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1705
Practice Address - Country:US
Practice Address - Phone:516-236-7475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001120103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty