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General NPI Number Information
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NPI Number | 1225712631
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Entity Type | Organization
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Legal Business Name | ATS ADVANCED BEHAVIOR THERAPY, LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 23427 133RD AVE STE 1
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City | ROSEDALE
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State | NY
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Zip | 11422-1303
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Country | US
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Telephone | 646-423-1286
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Fax | 718-525-3131
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S # 824230
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City | NEW YORK
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State | NY
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Zip | 10003-1502
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Country | US
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Telephone | 646-423-1286
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Fax | 718-525-3131
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Authorized Official
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Title or Position | FOUNDER/ CEO
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Name | DR. TERRY S AUDATE
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Credential | DSW, LCSW-R
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Telephone | 646-423-1286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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