Provider Demographics
NPI:1790237592
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:PHD
Authorized Official - Phone:602-441-2388
Mailing Address - Street 1:200 S 3RD AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-2224
Mailing Address - Country:US
Mailing Address - Phone:928-919-1528
Mailing Address - Fax:
Practice Address - Street 1:200 S 3RD AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2224
Practice Address - Country:US
Practice Address - Phone:928-919-1528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-15037101YA0400X
AZCSLG7866101YP2500X, 251B00000X, 261QM0801X, 261QM0850X, 261QR0400X
AZ4010103TC0700X
AZ4605103TC1900X
AZLCSW-109621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBH5020OtherADHS