Provider Demographics
NPI:1053810234
Name:COMPREHENSIVE LICENSED BEHAVIOR ANALYST, PLLC.
Entity type:Organization
Organization Name:COMPREHENSIVE LICENSED BEHAVIOR ANALYST, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATARZYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTYLEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-623-9440
Mailing Address - Street 1:6264 SAUNDERS ST APT D3
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1510
Mailing Address - Country:US
Mailing Address - Phone:646-623-9440
Mailing Address - Fax:
Practice Address - Street 1:6264 SAUNDERS ST APT D3
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1510
Practice Address - Country:US
Practice Address - Phone:646-623-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000441103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty