NPIMap

Organization Active NPI

Specialized Behavior Solutions

  • Behavior Analyst
  • Whitwell, TN
National Provider Identifier
1760972202
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0000000169 Issued in TN
Legal business name
SPECIALIZED BEHAVIOR SOLUTIONS
Practice address
360 Looneys Creek Dr
Whitwell, TN 37397
Phone
(423) 902-8137
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Authorized official

Name
Nichole J Henry, BCBA, LBANPI 1225259377
Title
Behavior Analyst
Phone
(423) 902-8137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X LBA0000000169 TN Primary

Addresses

Primary practice location

360 Looneys Creek Dr
Whitwell, TN 37397

Mailing address

360 Looneys Creek Dr
Whitwell, TN 37397
Phone (423) 902-8137

Other identifiers 1

IdentifierTypeStateIssuer
Q034752MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1760972202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 LOONEYS CREEK DR",
            "city": "WHITWELL",
            "state": "TN",
            "postal_code": "37397",
            "telephone_number": "423-902-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 LOONEYS CREEK DR",
            "city": "WHITWELL",
            "state": "TN",
            "postal_code": "37397",
            "telephone_number": "423-902-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED BEHAVIOR SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "423-902-8137",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "LBA0000000169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034752",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitwell, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.