Provider Demographics
NPI:1619345303
Name:THERAPEUTIC BEHAVIORAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:THERAPEUTIC BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVILACQUA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:914-290-5797
Mailing Address - Street 1:240 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1218
Mailing Address - Country:US
Mailing Address - Phone:914-290-5797
Mailing Address - Fax:
Practice Address - Street 1:240 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1218
Practice Address - Country:US
Practice Address - Phone:914-290-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088722788251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health