Provider Demographics
NPI:1851174080
Name:INSIGHT THERAPY SERVICES APPLIED BEHAVIOR ANALYSIS AND MENTAL HEALT
Entity Type:Organization
Organization Name:INSIGHT THERAPY SERVICES APPLIED BEHAVIOR ANALYSIS AND MENTAL HEALT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-921-4269
Mailing Address - Street 1:100 CENTERSHORE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1527
Mailing Address - Country:US
Mailing Address - Phone:631-921-4269
Mailing Address - Fax:
Practice Address - Street 1:100 CENTERSHORE RD STE 7
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1527
Practice Address - Country:US
Practice Address - Phone:631-921-4269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty