Healthcare Provider Details

I. General information

NPI: 1124499546
Provider Name (Legal Business Name): APPLIED BEHAVIORSOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N MIAMI BEACH BLVD SUITE #301
NORTH MIAMI BEACH FL
33162-3712
US

IV. Provider business mailing address

909 N MIAMI BEACH BLVD SUITE #301
NORTH MIAMI BEACH FL
33162-3712
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-7202
  • Fax: 305-822-7203
Mailing address:
  • Phone: 305-822-7202
  • Fax: 305-822-7203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSW6104
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberSW6104
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH LEON BERG
Title or Position: CLINICAL DIRECTOR
Credential: PSYD, BCBA
Phone: 305-822-7202