Provider Demographics
NPI:1740801869
Name:DEVELOPING MINDS THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:DEVELOPING MINDS THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MAP, BCBA, LBA
Authorized Official - Phone:314-626-0306
Mailing Address - Street 1:2 CITYPLACE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7055
Mailing Address - Country:US
Mailing Address - Phone:314-626-0306
Mailing Address - Fax:314-689-0306
Practice Address - Street 1:2 CITYPLACE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7055
Practice Address - Country:US
Practice Address - Phone:314-626-0306
Practice Address - Fax:314-689-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty