Active NPI
Max Edward Tice, BCBA
- Behavior Analyst
- Lawrenceburg, TN
National Provider Identifier
1144499179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA0000000064
- Practice address
- 1114 Carey Cir
Lawrenceburg, TN 38464-2974 - Phone
- (931) 629-0944
- Fax
- (931) 762-6532
- NPI assigned
- Feb 24, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LBA0000000064 | TN | Primary |
Addresses
Primary practice location
1114 Carey Cir
Lawrenceburg, TN 38464-2974
Mailing address
1114 Carey Cir
1114 Carey Circle
Lawrenceburg, TN 38464-2974
Phone (931) 629-0944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LBA0000000064 | TN | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1144499179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 CAREY CIR",
"address_2": "1114 CAREY CIRCLE",
"city": "LAWRENCEBURG",
"state": "TN",
"postal_code": "384642974",
"telephone_number": "931-629-0944",
"fax_number": "931-762-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 CAREY CIR",
"city": "LAWRENCEBURG",
"state": "TN",
"postal_code": "384642974",
"telephone_number": "931-629-0944",
"fax_number": "931-762-6532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICE",
"first_name": "MAX",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-24",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "LBA0000000064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.