Provider Demographics
NPI:1619862307
Name:LAYVANT, RENATA (BSC)
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:LAYVANT
Suffix:
Gender:F
Credentials:BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4612
Mailing Address - Country:US
Mailing Address - Phone:267-904-7815
Mailing Address - Fax:
Practice Address - Street 1:536 MAPLE ST
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4612
Practice Address - Country:US
Practice Address - Phone:267-904-7815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004726103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst