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Miranda Amick

Individual provider Active NPI Assistant Behavior Analyst · Davis, WV

NPI 1356973614 · NPPES record last updated Dec 21, 2022

Key facts

NPI
1356973614
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
Practice address
25 Thistle LN
Davis, WV 26260-1104
Phone
(304) 801-3258
Fax
(304) 362-0025
NPI assigned
Feb 5, 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
Mountainside Behavior Analysis Services, LCC Current
since Feb 1, 2020		 Accepting new patients

Locations

79 Vicksburg Rd
Buckhannon, WV 26201
Phone (304) 801-3258

1107 S Davis Ave
Elkins, WV 26241
Phone (304) 801-3258

1111 S Davis Ave
Elkins, WV 26241

1614 Locust Ave
Fairmont, WV 26554
Phone (304) 801-3258

601 Locust Ave
Fairmont, WV 26554

6127 Winchester Ave
Inwood, WV 25428
Phone (304) 801-3258

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Yes

Addresses

Primary practice location

25 Thistle LN
Davis, WV 26260-1104

Mailing address

25 Thistle LN
Davis, WV 26260-1104
Phone (304) 801-3258

Other practice location 1

1614 Locust Ave
Fairmont, WV 26554-1319
Phone (304) 801-3258

Other practice location 2

1107 S Davis Ave
Elkins, WV 26241-8703
Phone (304) 801-3258

Other providers in Davis, WV

All providers in Davis, WV · Assistant Behavior Analyst in West Virginia

Sources for this page

Verify at the official NPI Registry.