Melissa Bean

Individual provider Active NPI Behavior Analyst · Niceville, FL

NPI 1164052254 · NPPES record last updated Jan 17, 2020

Key facts

NPI
1164052254
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-19-39290 (VA)
Practice address
4673 E Highway 20
Niceville, FL 32578-9796
Phone
(850) 607-6910
Fax
(850) 607-6932
NPI assigned
Jan 17, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Applied Behavior Analysis Behavior Analyst Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-39290 VA Yes

Addresses

Primary practice location

4673 E Highway 20
Niceville, FL 32578-9796

Mailing address

3771 Stefani Rd
Cantonment, FL 32533-7795
Phone (850) 607-6910

Other providers in Niceville, FL

All providers in Niceville, FL · Behavior Analyst in Florida

Sources for this page

Verify at the official NPI Registry.