Provider Demographics
NPI:1801372552
Name:BEHAVIOR ANALYTIC SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIOR ANALYTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEECHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-961-7898
Mailing Address - Street 1:700 JAMES CIR NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5613
Mailing Address - Country:US
Mailing Address - Phone:321-961-7898
Mailing Address - Fax:
Practice Address - Street 1:700 JAMES CIR NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905
Practice Address - Country:US
Practice Address - Phone:321-961-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-17-7660106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-17-7660OtherASSISTANT BEHAVIOR ANALYST