Provider Demographics
NPI:1881470029
Name:COUNITEDLLC
Entity type:Organization
Organization Name:COUNITEDLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GLUNT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:260-413-1260
Mailing Address - Street 1:5736 COUNTESS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-7414
Mailing Address - Country:US
Mailing Address - Phone:260-413-1260
Mailing Address - Fax:
Practice Address - Street 1:5736 COUNTESS DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-7414
Practice Address - Country:US
Practice Address - Phone:260-413-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNITED LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-05
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty