Provider Demographics
NPI:1457142531
Name:BEHAVIORAL THERAPY SPECIALIST LLC
Entity type:Organization
Organization Name:BEHAVIORAL THERAPY SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-223-0989
Mailing Address - Street 1:381 W 29TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5707
Mailing Address - Country:US
Mailing Address - Phone:786-223-0989
Mailing Address - Fax:786-364-0119
Practice Address - Street 1:381 W 29TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5707
Practice Address - Country:US
Practice Address - Phone:786-223-0989
Practice Address - Fax:786-364-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty