=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619885977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLIN BEHAVIORAL SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2026
-----------------------------------------------------
Last Update Date | 08/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 895 CENTENNIAL AVE
-----------------------------------------------------
City | NORTH BALDWIN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11510-1914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-907-4080
-----------------------------------------------------
Fax | 516-966-0084
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 280028
-----------------------------------------------------
City | QUEENS VILLAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11428-0028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-907-4080
-----------------------------------------------------
Fax | 516-966-0084
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TEACHER
-----------------------------------------------------
Name | MS. REGINE SYBIL COLIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-907-4080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------