Zachary Alexander Dale Cleveland
Individual provider Active NPI Behavior Analyst · Munford, AL
NPI 1215570288 · NPPES record last updated Feb 28, 2023
Key facts
- NPI
- 1215570288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 2021-047 (AL)
- Practice address
- 255 Lake Joan Cir
Munford, AL 36268-7154 - Phone
- (256) 252-7902
- NPI assigned
- Oct 23, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021-047 | AL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gains Behavioral Services LLC | Behavior Analyst | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2021-047 | AL | Yes |
Addresses
Primary practice location
255 Lake Joan Cir
Munford, AL 36268-7154
Mailing address
255 Lake Joan Cir
Munford, AL 36268-7154
Phone (256) 252-7902
Other providers in Munford, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.