Phoenix Rising Behavioral Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PHOENIX RISING BEHAVIORAL SERVICES LLC

Practice address

12638 Ridgeline Blvd Apt 6304
Cedar Park, TX 78613-1212

Phone

(512) 761-6775

Fax

(737) 367-3007

NPI assigned

Jul 26, 2024

Organization subpart

No

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

Authorized official

Name

Stephanie Waldon, BCBA, LBANPI 1831791201

Title

Board Certified Behavior Analyst

Phone

(512) 761-6775

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Waldon, BCBA

  • Behavior Analyst
  • Killeen, TX
  • NPI 1831791201
  NPD Authorized official

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1114756475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12638 RIDGELINE BLVD APT 6304",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786131212",
            "telephone_number": "254-677-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12638 RIDGELINE BLVD APT 6304",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786131212",
            "telephone_number": "512-761-6775",
            "fax_number": "737-367-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "WALDON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "512-761-6775",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yonatan Pevzner, DDS
• Hong-Ngoc Pham
• Toai Cong Pham, D.D.S.
• Doan Phan, LCSW
• Quynh-Nhu Tan Phan, D.D.S.
• Physiotherapy Associates, Inc.
• Nancy Pickett, RN
• Pilates Island Studio
• Paulina Alejandra Pina, LPC
• Caroline Pirkle

• Behavior Analyst in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.