Provider Demographics
NPI:1396405296
Name:BEHAVIOR CONNECTIONS LLC
Entity Type:Organization
Organization Name:BEHAVIOR CONNECTIONS LLC
Other - Org Name:BEHAVIOR CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:360-628-0993
Mailing Address - Street 1:9601 339TH ST S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:WA
Mailing Address - Zip Code:98580-9480
Mailing Address - Country:US
Mailing Address - Phone:360-628-0993
Mailing Address - Fax:
Practice Address - Street 1:9601 339TH ST S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:WA
Practice Address - Zip Code:98580-9480
Practice Address - Country:US
Practice Address - Phone:360-628-0993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty