Creative Behavior Services Licensed Behavior Analyst PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

CREATIVE BEHAVIOR SERVICES LICENSED BEHAVIOR ANALYST PLLC

Practice address

108-14 72ND Avenue
2ND FL
Forest Hills, NY 11375

Phone

(718) 938-1256

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Demetrius Fincher

Title

Program Director

Phone

(718) 938-1256

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1821667890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-14 72ND AVENUE",
            "address_2": "2ND FL",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108-14 72ND AVENUE",
            "address_2": "2ND FL",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-938-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE BEHAVIOR SERVICES LICENSED BEHAVIOR ANALYST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "FINCHER",
        "authorized_official_first_name": "DEMETRIUS",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "718-938-1256"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Forest Hills, NY
• Providers in Forest Hills, 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 Jun 23, 2021; 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.