MEDICARE: ELEMENTS LICENSED BEHAVIOR ANALYST PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1629947106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEMENTS LICENSED BEHAVIOR ANALYST PLLC

Provider Business Mailing Address
First Line	:	63 NEW MAIN ST
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 NEW MAIN ST
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1859
Country	:	US
Telephone Number	:	845-652-3365
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEYER MORRIS ROKOWSKY
Credential	:
Telephone Number	:	888-860-3160

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	03/06/2026

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