Provider Demographics
NPI:1972295830
Name:BEYOND THE SPECTRUM LLC
Entity Type:Organization
Organization Name:BEYOND THE SPECTRUM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD BCBA-D
Authorized Official - Phone:910-231-1909
Mailing Address - Street 1:5204 TREYBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-2745
Mailing Address - Country:US
Mailing Address - Phone:910-231-1909
Mailing Address - Fax:843-774-1858
Practice Address - Street 1:3332 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5942
Practice Address - Country:US
Practice Address - Phone:910-231-1909
Practice Address - Fax:843-774-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty