Provider Demographics
NPI:1831827419
Name:HAIM LICENSED BEHAVIOR ANALYST PLLC
Entity type:Organization
Organization Name:HAIM LICENSED BEHAVIOR ANALYST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARRA
Authorized Official - Middle Name:MALKA
Authorized Official - Last Name:RUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:347-229-7972
Mailing Address - Street 1:3611 14TH AVE STE 426
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3787
Mailing Address - Country:US
Mailing Address - Phone:718-750-4246
Mailing Address - Fax:
Practice Address - Street 1:3611 14TH AVE STE 426
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3787
Practice Address - Country:US
Practice Address - Phone:718-750-4246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty