Provider Demographics
NPI:1376334318
Name:MODEL BEHAVIOR MANAGEMENT LLC
Entity type:Organization
Organization Name:MODEL BEHAVIOR MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BASCLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBA
Authorized Official - Phone:985-226-3178
Mailing Address - Street 1:1363 DOCTOR BEATROUS RD
Mailing Address - Street 2:
Mailing Address - City:THERIOT
Mailing Address - State:LA
Mailing Address - Zip Code:70397-9633
Mailing Address - Country:US
Mailing Address - Phone:985-226-3178
Mailing Address - Fax:
Practice Address - Street 1:108 PICONE RD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-7051
Practice Address - Country:US
Practice Address - Phone:985-226-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty