Provider Demographics
NPI:1083591531
Name:PARADIGM SHIFT OF NEW YORK
Entity type:Organization
Organization Name:PARADIGM SHIFT OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHELY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:631-827-9189
Mailing Address - Street 1:25021 NORTHERN BLVD LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1353
Mailing Address - Country:US
Mailing Address - Phone:631-827-9189
Mailing Address - Fax:
Practice Address - Street 1:25021 NORTHERN BLVD LOWR 250-21
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1353
Practice Address - Country:US
Practice Address - Phone:631-827-9189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty