Charity Burt

Individual provider Active NPI Behavior Technician · Ridgeland, MS

NPI 1730901604 · NPPES record last updated Oct 30, 2024

Key facts

NPI
1730901604
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
402B Legacy Park
Ridgeland, MS 39157-4315
Phone
(769) 233-7154
NPI assigned
Oct 30, 2024
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
Blue Sky Behavior Therapy Current
since Nov 3, 2024
Accepting new patients

Locations

402B Legacy Park
Ridgeland, MS 39157

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

402B Legacy Park
Ridgeland, MS 39157-4315

Mailing address

124 Hunt Cir
Madison, MS 39110-9536

Other providers in Ridgeland, MS

All providers in Ridgeland, MS · Behavior Technician in Mississippi

Sources for this page

Verify at the official NPI Registry.