Provider Demographics
NPI:1497476840
Name:BEHAVIORAL ADVANCEMENT THERAPY CORP
Entity Type:Organization
Organization Name:BEHAVIORAL ADVANCEMENT THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JINELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LMHC
Authorized Official - Phone:305-788-2491
Mailing Address - Street 1:15250 SW 154TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-5437
Mailing Address - Country:US
Mailing Address - Phone:305-788-2491
Mailing Address - Fax:
Practice Address - Street 1:12485 SW 137TH AVE STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4217
Practice Address - Country:US
Practice Address - Phone:305-788-2491
Practice Address - Fax:561-923-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty