Provider Demographics
NPI:1922152768
Name:BEHAVIOR WORKS CORPORATION
Entity Type:Organization
Organization Name:BEHAVIOR WORKS CORPORATION
Other - Org Name:BEHAVIOR WORKS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:BRATER
Authorized Official - Last Name:CUOMO
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, BCBA, LMHC
Authorized Official - Phone:321-543-6729
Mailing Address - Street 1:PO BOX 37-2068
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-2068
Mailing Address - Country:US
Mailing Address - Phone:321-543-6729
Mailing Address - Fax:321-631-3400
Practice Address - Street 1:759 WHITE PINE AVE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-8143
Practice Address - Country:US
Practice Address - Phone:321-543-6729
Practice Address - Fax:321-631-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-7903101YM0800X
FLSS-664103TS0200X
FLSW-75001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL346537OtherHARMONY BEHAVIORAL