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General NPI Number Information
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NPI Number | 1386004703
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL ASSOCIATION, LLC
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Dates
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Enumeration Date | 02/26/2016
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 7925 NW 12TH ST STE 118
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City | DORAL
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State | FL
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Zip | 33126-1820
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Country | US
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Telephone | 786-379-7602
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Fax | 786-800-5517
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Provider Business Mailing Address
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Address Line | 2721 SW 92ND CT
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City | MIAMI
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State | FL
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Zip | 33165-3127
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Country | US
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Telephone | 786-379-7602
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Fax | 786-800-5517
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Authorized Official
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Title or Position | PRESIDENT
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Name | VARINIA F CABRERA
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Credential | PSYD
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Telephone | 786-379-7602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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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 | 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 #5
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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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Taxonomy #6
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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