Provider Demographics
NPI:1689330375
Name:PIVOTAL BEHAVIOR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PIVOTAL BEHAVIOR SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:434-426-2244
Mailing Address - Street 1:262 CRESCENT LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:VA
Mailing Address - Zip Code:24574-3202
Mailing Address - Country:US
Mailing Address - Phone:434-426-2244
Mailing Address - Fax:
Practice Address - Street 1:262 CRESCENT LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:VA
Practice Address - Zip Code:24574-3202
Practice Address - Country:US
Practice Address - Phone:434-426-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health