Provider Demographics
NPI:1811510134
Name:LICENSED APPLIED BEHAVIOR ANALYSIS SERVICES OF NEW YORK P.C.
Entity type:Organization
Organization Name:LICENSED APPLIED BEHAVIOR ANALYSIS SERVICES OF NEW YORK P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, BCBA, NYS LBA
Authorized Official - Phone:347-697-0904
Mailing Address - Street 1:25 DOLPHIN GRN APT G2C
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3163
Mailing Address - Country:US
Mailing Address - Phone:347-697-0904
Mailing Address - Fax:
Practice Address - Street 1:25 DOLPHIN GRN APT G2C
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3163
Practice Address - Country:US
Practice Address - Phone:347-697-0904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty