Branch Out Licensed Behavior Analysts, PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BRANCH OUT LICENSED BEHAVIOR ANALYSTS, PLLC

Practice address

81 Fleet PL Apt 16C
Brooklyn, NY 11201-8022

Phone

(952) 215-6608

Fax

(952) 215-6608

NPI assigned

Dec 4, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sarah Camp Camp, LBA

Title

Clinical Director

Phone

(908) 391-8760

Specialties & licenses 1

Addresses

Other names 1

• Teamwork Licensed Behavior Analysts, PLLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Dalfen, PH.D., BCBA-D, LBA

  • Behavior Analyst
  • Brooklyn, NY
  • NPI 1770943664
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1396250064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 PRINCE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013022",
            "telephone_number": "908-391-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 FLEET PL APT 16C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112018022",
            "telephone_number": "952-215-6608",
            "fax_number": "952-215-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20942 34th Ave",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113611448",
            "country_code": "US",
            "telephone_number": "516-728-1003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRANCH OUT LICENSED BEHAVIOR ANALYSTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "SARAH CAMP",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "908-391-8760",
        "authorized_official_credential": "LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teamwork Licensed Behavior Analysts, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Behavior Analyst in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.