Provider Demographics
NPI:1891209888
Name:BEHAVIORAL HEALTH ASSOCIATES, LCSW PC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH ASSOCIATES, LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-297-1847
Mailing Address - Street 1:3 WHITEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9323
Mailing Address - Country:US
Mailing Address - Phone:516-297-1847
Mailing Address - Fax:631-821-1362
Practice Address - Street 1:131 RT. 25A
Practice Address - Street 2:SUITE 4
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:516-297-1847
Practice Address - Fax:631-821-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR025937-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNOI101OtherPTAN