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General NPI Number Information
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NPI Number | 1669884409
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Entity Type | Organization
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Legal Business Name | COGNITIVE BEHAVIOR INSTITUTE, LLC
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 2009 MACKENZIE WAY SUITE 100
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-5332
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Country | US
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Telephone | 724-814-9708
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Fax |
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Provider Business Mailing Address
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Address Line | 168 SOUTHRIDGE DR
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-2404
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Country | US
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Telephone | 724-814-9708
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Fax |
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Authorized Official
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Title or Position | FOUNDER / DIRECTOR
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Name | MR. KEVIN CARIDAD
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Credential | LCSW
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Telephone | 724-814-9708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW017308
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License Number State | PA
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