Provider Demographics
NPI:1811320435
Name:ACCESSIBLE BEHAVIOR, LLC
Entity type:Organization
Organization Name:ACCESSIBLE BEHAVIOR, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEDDOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-403-8206
Mailing Address - Street 1:100 BRIAN CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4340
Mailing Address - Country:US
Mailing Address - Phone:615-403-8206
Mailing Address - Fax:615-301-6196
Practice Address - Street 1:100 BRIAN CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4340
Practice Address - Country:US
Practice Address - Phone:615-403-8206
Practice Address - Fax:615-301-6196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5228235Z00000X
CO1-12-11796103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1524627Medicaid