Provider Demographics
NPI:1902363682
Name:ACCELERATE BEHAVIOR INTERNATIONAL, LLC
Entity Type:Organization
Organization Name:ACCELERATE BEHAVIOR INTERNATIONAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:240-374-9965
Mailing Address - Street 1:1113 OAKDALE DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2302
Mailing Address - Country:US
Mailing Address - Phone:301-559-9035
Mailing Address - Fax:
Practice Address - Street 1:15518 NORGE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1378
Practice Address - Country:US
Practice Address - Phone:240-274-9965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD078005000Medicaid