Provider Demographics
NPI:1831608207
Name:UNLIMITED POSSIBILITIES BEHAVIOR & TRANSITIONS SUPPORT, LLC
Entity type:Organization
Organization Name:UNLIMITED POSSIBILITIES BEHAVIOR & TRANSITIONS SUPPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST/CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:850-569-5827
Mailing Address - Street 1:5865 NEALS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:BASCOM
Mailing Address - State:FL
Mailing Address - Zip Code:32423-9213
Mailing Address - Country:US
Mailing Address - Phone:850-569-5827
Mailing Address - Fax:
Practice Address - Street 1:4438 DAVIS ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-3125
Practice Address - Country:US
Practice Address - Phone:850-272-6099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17417368844106S00000X
FL1-16-23058103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty