Healthcare Provider Details

I. General information

NPI: 1346839115
Provider Name (Legal Business Name): TREETOP THERAPY GA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 PEACHTREE ROAD NE #1800
ATLANTA GA
30326
US

IV. Provider business mailing address

1 STATE STREET PLAZA 29TH FLOOR
NEW YORK NY
10004-1561
US

V. Phone/Fax

Practice location:
  • Phone: 516-206-8900
  • Fax: 516-926-0190
Mailing address:
  • Phone: 516-206-8900
  • 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 Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JUDAH SCHILLER
Title or Position: MANAGING PARTNER
Credential:
Phone: 516-206-8900