Healthcare Provider Details

I. General information

NPI: 1316607351
Provider Name (Legal Business Name): APPLIED BEHAVIORAL INTERVENTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 12/17/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 E 14TH ST STE 200
BROOKLYN NY
11235-3973
US

IV. Provider business mailing address

2625 E 14TH ST STE 200
BROOKLYN NY
11235-3973
US

V. Phone/Fax

Practice location:
  • Phone: 718-769-2698
  • Fax:
Mailing address:
  • Phone: 718-769-2698
  • 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 Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN SHAY
Title or Position: FINANCE MANAGER
Credential:
Phone: 718-769-2698