Provider Demographics
NPI:1336683721
Name:LEARNING AND BEHAVIOR SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:LEARNING AND BEHAVIOR SOLUTIONS, LLC.
Other - Org Name:TIFFANY MRLA
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KMITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-294-0088
Mailing Address - Street 1:1022 JONES RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0705
Mailing Address - Country:US
Mailing Address - Phone:479-318-2300
Mailing Address - Fax:
Practice Address - Street 1:1022 JONES RD STE 2
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0705
Practice Address - Country:US
Practice Address - Phone:479-418-9584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1-14-1043103K00000X
103K00000X, 235Z00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR216666706Medicaid