Provider Demographics
NPI:1083048433
Name:BEHAVIOR ANALYSIS SERVICES IN COMMUNITY SETTINGS
Entity Type:Organization
Organization Name:BEHAVIOR ANALYSIS SERVICES IN COMMUNITY SETTINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEAT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA,CMHP
Authorized Official - Phone:850-572-6865
Mailing Address - Street 1:5165 ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8902
Mailing Address - Country:US
Mailing Address - Phone:850-572-6865
Mailing Address - Fax:850-492-2645
Practice Address - Street 1:5165 ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8902
Practice Address - Country:US
Practice Address - Phone:850-572-6865
Practice Address - Fax:850-492-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL70506101YM0800X
FL0537103K00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty