Provider Demographics
NPI:1497483945
Name:SUPERHERO BEHAVIOR LLC
Entity Type:Organization
Organization Name:SUPERHERO BEHAVIOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:630-362-5979
Mailing Address - Street 1:412 SUDBURY CIR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7149
Mailing Address - Country:US
Mailing Address - Phone:630-362-5979
Mailing Address - Fax:
Practice Address - Street 1:412 SUDBURY CIR
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7149
Practice Address - Country:US
Practice Address - Phone:630-362-5979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty