Provider Demographics
NPI:1841360583
Name:CLINICAL BEHAVIOR ANALYSIS, LLC
Entity type:Organization
Organization Name:CLINICAL BEHAVIOR ANALYSIS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:NEEL
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:210-865-7734
Mailing Address - Street 1:3106 KNIGHT ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3534
Mailing Address - Country:US
Mailing Address - Phone:210-865-7734
Mailing Address - Fax:210-657-7402
Practice Address - Street 1:10615 PERRIN BEITEL RD
Practice Address - Street 2:SUITE #801
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3138
Practice Address - Country:US
Practice Address - Phone:210-865-7734
Practice Address - Fax:512-524-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-02-0855103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty