NPIMap

Organization Active NPI

Behavior Change Consultants, LLC

  • Behavior Analyst
  • Largo, FL
National Provider Identifier
1235375866
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1000085 Issued in FL
Legal business name
BEHAVIOR CHANGE CONSULTANTS, LLC
Practice address
1158 Fountainhead Dr
Largo, FL 33770-4228
Phone
(727) 586-5785
Fax
(727) 585-4214
NPI assigned
Jan 3, 2009
Reactivated
Apr 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Authorized official

Name
Kay Darlene Brynildson, BCBANPI 1801037288
Title
President
Phone
(727) 586-5785

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1000085 FL Primary

Addresses

Primary practice location

1158 Fountainhead Dr
Largo, FL 33770-4228

Mailing address

1158 Fountainhead Dr
Largo, FL 33770-4228
Phone (727) 586-5785

Other identifiers 2

IdentifierTypeStateIssuer
686320596OtherFLMEDWAIVER HCBS
686320598OtherFLMEDWAIVER HCBS/FSL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1230940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1235375866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 FOUNTAINHEAD DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337704228",
            "telephone_number": "727-586-5785",
            "fax_number": "727-585-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 FOUNTAINHEAD DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337704228",
            "telephone_number": "727-586-5785",
            "fax_number": "727-585-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIOR CHANGE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-03",
        "last_updated": "2009-04-27",
        "deactivation_date": "2009-04-06",
        "reactivation_date": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "BRYNILDSON",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-586-5785",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1000085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER HCBS",
            "identifier": "686320596",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER HCBS/FSL",
            "identifier": "686320598",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.