Provider Demographics
NPI:1386016798
Name:NEW BEGINNINGS BEHAVIOR THERAPY, LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS BEHAVIOR THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERANDA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:317-439-0429
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:3830
Mailing Address - City:CLAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:46118-0360
Mailing Address - Country:US
Mailing Address - Phone:317-439-0429
Mailing Address - Fax:
Practice Address - Street 1:4930 IOWA ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:IN
Practice Address - Zip Code:46118-9510
Practice Address - Country:US
Practice Address - Phone:317-439-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-13806103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty