Provider Demographics
NPI:1851732796
Name:EXCEPTIONAL BEHAVIOR CONSULTING, LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL BEHAVIOR CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:727-742-7872
Mailing Address - Street 1:11454 127TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-1913
Mailing Address - Country:US
Mailing Address - Phone:727-742-7872
Mailing Address - Fax:877-271-9338
Practice Address - Street 1:12651 WALSINGHAM RD STE A
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3627
Practice Address - Country:US
Practice Address - Phone:727-742-7872
Practice Address - Fax:877-271-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018616500Medicaid
FL009628000Medicaid