Provider Demographics
NPI:1639922628
Name:EVEREST APPLIED BEHAVIOR ANALYSIS
Entity type:Organization
Organization Name:EVEREST APPLIED BEHAVIOR ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:F
Authorized Official - Last Name:BLUMENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED BCBA NY-LBA
Authorized Official - Phone:845-210-9108
Mailing Address - Street 1:22 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-1613
Mailing Address - Country:US
Mailing Address - Phone:862-571-9452
Mailing Address - Fax:845-241-3320
Practice Address - Street 1:22 WOODRIDGE DR
Practice Address - Street 2:
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984-1613
Practice Address - Country:US
Practice Address - Phone:862-571-9452
Practice Address - Fax:862-571-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty