Provider Demographics
NPI:1750110797
Name:NICOLETTE SCROZZO BEHAVIOR CONSULTATION LLC
Entity type:Organization
Organization Name:NICOLETTE SCROZZO BEHAVIOR CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCROZZO
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA
Authorized Official - Phone:631-487-4625
Mailing Address - Street 1:8 GILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5308
Mailing Address - Country:US
Mailing Address - Phone:631-487-4625
Mailing Address - Fax:
Practice Address - Street 1:135 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1635
Practice Address - Country:US
Practice Address - Phone:631-487-4625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst