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Last 4 digits of SS#American Institute for Cognitive Therapy 150 East 58th Street, 5th Floor Annex, New York, N.Y. 10155telephone: (212) 3082440 fax: (212) 3083099 email: intake@cognitivetherapynyc.comNotice

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5. Answer any questions or sections that apply to your application or membership status.
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