Healthcare Provider Details

I. General information

NPI: 1699172239
Provider Name (Legal Business Name): APPLIED BEHAVIORAL MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 SHERIDAN ST STE 501
HOLLYWOOD FL
33021-3435
US

IV. Provider business mailing address

4601 SHERIDAN ST STE 501
HOLLYWOOD FL
33021-3435
US

V. Phone/Fax

Practice location:
  • Phone: 866-352-5010
  • Fax:
Mailing address:
  • Phone: 866-352-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number006000
License Number StateNY

VIII. Authorized Official

Name: YECHESKEL YAKOV HALBERSTAM
Title or Position: OFFICER
Credential:
Phone: 866-352-5010