Provider Demographics
NPI:1760251839
Name:ABEL LICENSED BEHAVIOR ANALYST
Entity Type:Organization
Organization Name:ABEL LICENSED BEHAVIOR ANALYST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:301-266-7993
Mailing Address - Street 1:68 RADCLIFFE AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-5221
Mailing Address - Country:US
Mailing Address - Phone:301-266-7993
Mailing Address - Fax:
Practice Address - Street 1:68 RADCLIFFE AVE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-5221
Practice Address - Country:US
Practice Address - Phone:301-266-7993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty