NPIMap

Organization Active NPI

Panhandle Behavioral Services, LLC

  • Behavior Analyst
  • Panama City, FL
National Provider Identifier
1134599624
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PANHANDLE BEHAVIORAL SERVICES, LLC
Practice address
1229 Airport Rd
Panama City, FL 32405-3527
Phone
(850) 215-6770
Fax
(850) 665-0123
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Mr. Charles Brent Martin, BCBANPI 1649640053
Title
Owner/Lead Behavior Analyst
Phone
(850) 326-6937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-10-6993 FL
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

1229 Airport Rd
Panama City, FL 32405-3527

Mailing address

1229 Airport Rd
Panama City, FL 32405-3527
Phone (850) 215-6770

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1134599624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053527",
            "telephone_number": "850-215-6770",
            "fax_number": "850-665-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053527",
            "telephone_number": "850-215-6770",
            "fax_number": "850-665-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANHANDLE BEHAVIORAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER/LEAD BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "850-326-6937",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-10-6993",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.