Provider Demographics
NPI:1194398040
Name:BEHAVIORAL PROGRESSION, INC
Entity Type:Organization
Organization Name:BEHAVIORAL PROGRESSION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MCLEAN
Authorized Official - Last Name:MINARD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:863-602-0698
Mailing Address - Street 1:1284 DEVIN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-2383
Mailing Address - Country:US
Mailing Address - Phone:863-602-0698
Mailing Address - Fax:813-354-2715
Practice Address - Street 1:10150 HIGHLAND MANOR DR STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9712
Practice Address - Country:US
Practice Address - Phone:863-602-0698
Practice Address - Fax:813-354-2715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEHAVIORAL PROGRESSION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty