OrganizationCreative Licensed Behavior Analyst P.C.Behavior AnalystBehavioral Health & Social Service ProvidersPractice Address6262 Woodhaven Blvd Apt S34, Rego Park, NY 11374-3726(646) 384-2385PECOS EnrollmentBased on the most recent information from CMS, provider Creative Licensed Behavior Analyst P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1285185595Provider TypeOrganizationFull NameCreative Licensed Behavior Analyst P.C.SubpartNoEnumeration Date10/21/2016Last Updated10/21/2016Contact InformationPractice LocationPractice Address6262 Woodhaven Blvd Apt S34, Rego Park, NY 11374-3726Phone(646) 384-2385FaxUnlisted FaxMailing LocationMailing Address6262 Woodhaven Blvd Apt S34, Rego Park, NY 11374-3726PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameAbramov, Sibila (Owner)Phone(646) 384-2385Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer