Provider Demographics
NPI:1619321908
Name:APPLIED BEHAVIORAL INTERVENTIONS, PLLC
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL INTERVENTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OKORIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-441-2388
Mailing Address - Street 1:PO BOX 72657
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1028
Mailing Address - Country:US
Mailing Address - Phone:602-524-0824
Mailing Address - Fax:800-881-7511
Practice Address - Street 1:10000 N 31ST AVE STE A107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9582
Practice Address - Country:US
Practice Address - Phone:602-441-2388
Practice Address - Fax:800-881-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-15037101YA0400X
AZLPC-13418101YP2500X
AZ4010103T00000X
AZLCSW-109621041C0700X
AZBH4777251S00000X
AZCSLG7643251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty