Healthcare Provider Details
I. General information
NPI: 1952672297
Provider Name (Legal Business Name): BEHAVIORAL HEALTH WORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2012
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12459 LEWIS ST STE 201
GARDEN GROVE CA
92840-6606
US
IV. Provider business mailing address
2733 E 12TH ST STE C2
BROOKLYN NY
11235-4672
US
V. Phone/Fax
- Phone: 800-249-1266
- Fax: 800-385-8191
- Phone: 800-249-1266
- Fax: 800-385-8191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-08-4069 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OT 7404 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SP 9175 |
| License Number State | CA |
VIII. Authorized Official
Name:
VICKIE
DRAZIN
Title or Position: OWNER
Credential:
Phone: 212-235-1231