Provider Demographics
NPI:1902507064
Name:LICENSED BEHAVIOR ANALYST SPECTRUM PLLC
Entity Type:Organization
Organization Name:LICENSED BEHAVIOR ANALYST SPECTRUM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAIGA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-275-4246
Mailing Address - Street 1:2389 ADAM CLAYTON POWELL JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2389 ADAM CLAYTON POWELL JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1710
Practice Address - Country:US
Practice Address - Phone:929-275-4246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty