Provider Demographics
NPI:1669908869
Name:NORTHEAST BEHAVIORAL ASSOCIATES
Entity type:Organization
Organization Name:NORTHEAST BEHAVIORAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:401-681-4637
Mailing Address - Street 1:2348 POST RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2258
Mailing Address - Country:US
Mailing Address - Phone:401-681-4637
Mailing Address - Fax:401-681-4675
Practice Address - Street 1:2348 POST RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2258
Practice Address - Country:US
Practice Address - Phone:401-681-4637
Practice Address - Fax:401-681-4675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILBA00099103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty