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General NPI Number Information
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NPI Number | 1992809016
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH SPECIALISTS, PLLC
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3 LEAR JET LN SUITE 105
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City | LATHAM
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State | NY
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Zip | 12110-2509
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Country | US
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Telephone | 518-785-3614
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Fax | 518-785-8786
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Provider Business Mailing Address
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Address Line | 3 LEAR JET LN SUITE 105
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City | LATHAM
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State | NY
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Zip | 12110-2509
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Country | US
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Telephone | 518-785-3614
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Fax | 518-785-8786
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. MARTIN JOSEPH MARRAZO
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Credential | PH.D.
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Telephone | 518-785-3614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4777
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 165902
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PR004365-1
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License Number State | NY
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