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General NPI Number Information
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NPI Number | 1922152768
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Entity Type | Organization
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Legal Business Name | BEHAVIOR WORKS CORPORATION
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 759 WHITE PINE AVE
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City | ROCKLEDGE
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State | FL
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Zip | 32955-8143
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Country | US
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Telephone | 321-543-6729
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Fax | 321-631-3400
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Provider Business Mailing Address
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Address Line | PO BOX 37-2068
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-2068
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Country | US
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Telephone | 321-543-6729
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Fax | 321-631-3400
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICOLE BRATER CUOMO
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Credential | EDS, BCBA, LMHC
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Telephone | 321-543-6729
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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 | MH-7903
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW-7500
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS-664
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License Number State | FL
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