Provider Demographics
NPI:1184896417
Name:COGNITIVE BEHAVIORAL ASSOCIATES, LLP
Entity type:Organization
Organization Name:COGNITIVE BEHAVIORAL ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:REED
Authorized Official - Last Name:DEROSA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-858-4328
Mailing Address - Street 1:29 BARSTOW RD STE 304
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2209
Mailing Address - Country:US
Mailing Address - Phone:516-858-4328
Mailing Address - Fax:
Practice Address - Street 1:29 BARSTOW RD STE 304
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2209
Practice Address - Country:US
Practice Address - Phone:516-858-4328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012978103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty