South Branch Behavioral Health & Education

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SOUTH BRANCH BEHAVIORAL HEALTH & EDUCATION

Practice address

241 Old Grove LN
Apex, NC 27502-7005

Phone

(919) 802-6202

NPI assigned

Mar 30, 2023

Last updated

Mar 30, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ken Dicob

Title

Administrator

Phone

(919) 802-6202

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1104521236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 OLD GROVE LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275027005",
            "telephone_number": "919-802-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 OLD GROVE LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275027005",
            "telephone_number": "919-802-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BRANCH BEHAVIORAL HEALTH & EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "DICOB",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-802-6202"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Apex, NC
• Providers in Apex, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.