Provider Demographics
NPI:1184237505
Name:ASPIRE BEHAVIORAL THERAPY
Entity type:Organization
Organization Name:ASPIRE BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:757-641-6455
Mailing Address - Street 1:923 WHISPER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-9516
Mailing Address - Country:US
Mailing Address - Phone:757-641-6455
Mailing Address - Fax:
Practice Address - Street 1:923 WHISPER HOLLOW DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-9516
Practice Address - Country:US
Practice Address - Phone:757-641-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty