The Olive Branch, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

THE OLIVE BRANCH, LLC

Practice address

1603 Capitol Ave Ste 303C
Cheyenne, WY 82001-4561

Phone

(910) 849-5517

NPI assigned

Aug 3, 2018

Last updated

Aug 3, 2018By 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

Tera CampbellNPI 1811365406

Title

Owner

Phone

(910) 849-5517

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tera Campbell, LMHC

  • Mental Health Counselor
  • Knoxville, TN
  • NPI 1811365406

  Behavior Analyst

  NPD (past) Authorized official
• Tayler Thompson

  • Behavior Technician
  • Cheyenne, WY
  • NPI 1649758343
  NPD (past)

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1114405875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 CAPITOL AVE STE 303C",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 CAPITOL AVE STE 303C",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014561",
            "telephone_number": "910-849-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OLIVE BRANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-849-5517"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Behavior Analyst in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.