Provider Demographics
NPI:1841680782
Name:NY BEHAVIOR ANALYSIS AND PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:NY BEHAVIOR ANALYSIS AND PSYCHOLOGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JIYEON
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:347-326-3695
Mailing Address - Street 1:18 ELMWOOD PARK DR
Mailing Address - Street 2:#A3
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7501
Mailing Address - Country:US
Mailing Address - Phone:347-326-3695
Mailing Address - Fax:
Practice Address - Street 1:40 EXCHANGE PL
Practice Address - Street 2:#1413
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2701
Practice Address - Country:US
Practice Address - Phone:646-780-9227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019959-1103TB0200X, 103TC0700X, 103TC2200X, 103TM1800X, 103T00000X
NY018399103TC0700X, 103T00000X, 103TC2200X, 103TB0200X, 103TM1800X
NY406103K00000X
NY325103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty