Provider Demographics
NPI:1649954942
Name:APPLIED BEHAVIORAL AND COGNITIVE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:APPLIED BEHAVIORAL AND COGNITIVE THERAPY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISETTE
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:RESTREPO
Authorized Official - Suffix:
Authorized Official - Credentials:PSY S, LSP, NCSP
Authorized Official - Phone:786-255-3752
Mailing Address - Street 1:11450 SW 105TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3129
Mailing Address - Country:US
Mailing Address - Phone:305-469-7582
Mailing Address - Fax:
Practice Address - Street 1:7001 SW 97TH AVE STE 206A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1410
Practice Address - Country:US
Practice Address - Phone:786-275-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty