Provider Demographics
NPI:1023311701
Name:APPLIED BEHAVIORAL SOLUTIONS LLC
Entity type:Organization
Organization Name:APPLIED BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOCOSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:516-840-0320
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:REEDERS
Mailing Address - State:PA
Mailing Address - Zip Code:18352-0491
Mailing Address - Country:US
Mailing Address - Phone:610-707-1487
Mailing Address - Fax:
Practice Address - Street 1:8604 MARJORIE LN
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-9244
Practice Address - Country:US
Practice Address - Phone:610-707-1487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-09-5708103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty