Healthcare Provider Details

I. General information

NPI: 1770120685
Provider Name (Legal Business Name): COGNITIVE AND BEHAVIORAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N BROADWAY
WHITE PLAINS NY
10601-2310
US

IV. Provider business mailing address

39 PRESCOTT AVE
WHITE PLAINS NY
10605-3105
US

V. Phone/Fax

Practice location:
  • Phone: 914-385-1150
  • Fax: 914-385-1155
Mailing address:
  • Phone: 914-202-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MELVILLE FRANCIS
Title or Position: STAFF PSYCHOLOGIST
Credential:
Phone: 914-385-1150