NPIMap

Organization Active NPI

Dynamic Behavior Solutions, LLC

  • Behavior Analyst
  • Madisonville, KY
National Provider Identifier
1245628874
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0048 Issued in KY
Legal business name
DYNAMIC BEHAVIOR SOLUTIONS, LLC
Practice address
2325 Ridgewood Dr
Madisonville, KY 42431-9411
Phone
(270) 339-0127
NPI assigned
Jan 5, 2015
Last updated
Jan 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Jodi Bauer, M.A.NPI 1487873535
Title
Board Certified Behavior Analyst
Phone
(270) 339-0127

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 0048 KY Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 0108 KY

Addresses

Primary practice location

2325 Ridgewood Dr
Madisonville, KY 42431-9411

Mailing address

PO Box 1591
Madisonville, KY 42431-0033
Phone (270) 339-0127

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1245628874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1591",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424310033",
            "telephone_number": "270-339-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 RIDGEWOOD DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319411",
            "telephone_number": "270-339-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC BEHAVIOR SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "270-339-0127",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "0048",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "0108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.