Organization
LIGHTHOUSE BEHAVIOR ANALYSTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAYA GOPIN BCBA (OWNER)
(646) 675-4945
Entity
Organization
Contact information
Practice address
13636 72ND AVE, FLUSHING, NY 11367-2328
(646) 675-4945
Mailing address
13636 72ND AVE, FLUSHING, NY 11367-2328
(646) 675-4945
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001604-1
STATE LICENSE
NY
Enumeration date
06/30/2020
Last updated
07/06/2020
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