NPIMap

Organization Active NPI

Behavior Networks

Doing business as LifeSong Academy

  • Behavior Analyst
  • Evansville, IN
National Provider Identifier
1275828923
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BEHAVIOR NETWORKS
Doing business as
LifeSong Academy
Practice address
1900 Stringtown Rd
Evansville, IN 47711-4522
Phone
(812) 490-2816
Fax
(812) 490-5631
NPI assigned
Jun 10, 2011
Last updated
Mar 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Authorized official

Name
Ms. Kimberly A Derk, MA, BCBA
Title
Owner, Ceo
Phone
(812) 490-2816

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1900 Stringtown Rd
Evansville, IN 47711-4522

Mailing address

1900 Stringtown Rd
Evansville, IN 47711-4522
Phone (812) 490-2816

Other names 1

  • LifeSong Academy Doing business as

National Provider Directory

National Provider Directory

Locations

1900 Stringtown Rd
Evansville, IN 47711
Phone (812) 490-2826

Practitioners & affiliated clinicians

Practitioners 5

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": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1275828923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 STRINGTOWN RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477114522",
            "telephone_number": "812-490-2816",
            "fax_number": "812-490-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STRINGTOWN RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477114522",
            "telephone_number": "812-490-2816",
            "fax_number": "812-490-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIOR NETWORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "DERK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "812-490-2816",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeSong Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.