Healthcare Provider Details

I. General information

NPI: 1841680782
Provider Name (Legal Business Name): NY BEHAVIOR ANALYSIS AND PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 EXCHANGE PL #1413
NEW YORK NY
10005-2701
US

IV. Provider business mailing address

18 ELMWOOD PARK DR #A3
STATEN ISLAND NY
10314-7501
US

V. Phone/Fax

Practice location:
  • Phone: 646-780-9227
  • Fax:
Mailing address:
  • Phone: 347-326-3695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number019959-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number019959-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number019959-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number019959-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number018399
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number018399
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number018399
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number018399
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number018399
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number406
License Number StateNY
# 11
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number019959-1
License Number StateNY
# 12
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number325
License Number StateNY

VIII. Authorized Official

Name: JIYEON HELEN YOO
Title or Position: CO-FOUNDER
Credential: PH.D., BCBA-D
Phone: 347-326-3695