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NPI Code Detail

MEDICARE: CANYON THERAPY INC.

MEDICARE: CANYON THERAPY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1114743093
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANYON THERAPY INC.
Provider Business Mailing Address
First Line : 580 5TH AVE STE 820
Second Line :
City : NEW YORK
State : NY
Zip : 10036-4762
Country : US
Telephone Number : 917-727-7072
Fax Number : 212-465-2510
Provider Business Practice Location Address
First Line : 580 5TH AVE STE 820
Second Line :
City : NEW YORK
State : NY
Zip : 10036-4762
Country : US
Telephone Number : 917-727-7072
Fax Number : 212-465-2510
Authorized Official
Title or Position : OWNER/BCBA
Name : HALEY MCPEEK
Credential : BCBA
Telephone Number : 917-727-7072
Provider Enumeration Date : 11/25/2024
Last Update Date : 04/15/2026

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Directions to “CANYON THERAPY INC. ” Practice Location

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