Pee-Wee's Behavioral Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PEE-WEE'S BEHAVIORAL SERVICES LLC

Practice address

2952 Little Bethel Rd
Green Sea, SC 29545-3729

Phone

(843) 489-1025

NPI assigned

May 19, 2023

Last updated

May 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sefa Bailey, BCBA 1-21-49684NPI 1720689946

Title

Owner

Phone

(843) 489-1025

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Sefa Bailey

  • Behavior Analyst
  • Green Sea, SC
  • NPI 1720689946
  NPD Authorized official
• Gianna Lee Simmons

  • Behavior Analyst
  • Green Sea, SC
  • NPI 1043985104
  NPD

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1629769583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 LITTLE BETHEL RD",
            "city": "GREEN SEA",
            "state": "SC",
            "postal_code": "295453729",
            "telephone_number": "843-489-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 LITTLE BETHEL RD",
            "city": "GREEN SEA",
            "state": "SC",
            "postal_code": "295453729",
            "telephone_number": "843-489-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE-WEE'S BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "SEFA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-489-1025",
        "authorized_official_credential": "BCBA 1-21-49684"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyton Fogarty
• Jodi Lennon, BCABA
• Little River Medical Center, Inc.
• Loris Community Hospital District (Mt Olive Family Health Center)
• McLeod Physician Associates II (Family Health Center - Mt. Olive)
• Gianna Lee Simmons
• Laquosha Smith, LPC, NCC

• Behavior Analyst in Green Sea, SC
• Providers in Green Sea, SC by specialty
• Behavior Analyst in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.