Organization Active NPI

To the Max Behavior Therapy, LLC

  • Behavior Analyst
  • Owensboro, KY
National Provider Identifier
1376296392
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
TO THE MAX BEHAVIOR THERAPY, LLC
Practice address
4225 Benttree Dr
Owensboro, KY 42301-8669
Phone
(270) 240-2846
Fax
(270) 246-9762
NPI assigned
Jan 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Nisa F Harper
Title
Admin Asst
Phone
(270) 316-3487

Specialties & licenses 1

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

Addresses

Primary practice location

4225 Benttree Dr
Owensboro, KY 42301-8669

Mailing address

4225 Benttree Dr
Owensboro, KY 42301-8669

Other identifiers 1

IdentifierTypeStateIssuer
7100461110MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
To the Max Behavior Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4225 Benttree Dr
Owensboro, KY 42301
Phone (270) 240-2846

Practitioners & affiliated clinicians

Practitioners 1

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": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1376296392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 BENTTREE DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423018669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 BENTTREE DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423018669",
            "telephone_number": "270-240-2846",
            "fax_number": "270-246-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TO THE MAX BEHAVIOR THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "NISA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMIN ASST",
        "authorized_official_telephone_number": "270-316-3487"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100461110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.