Melinda Black, RBT
Individual provider Active NPI Behavior Technician · Lewisburg, TN
NPI 1801320387 · NPPES record last updated Apr 12, 2017
Key facts
- NPI
- 1801320387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-16-21913 (TN)
- Practice address
- 1600 Jason Maxwell Blvd
Lewisburg, TN 37091-2018 - Phone
- (931) 359-1197
- Fax
- (931) 359-7705
- NPI assigned
- Apr 12, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-21913 | TN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Development Center | Behavior Technician | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-16-21913 | TN | Yes |
Addresses
Primary practice location
1600 Jason Maxwell Blvd
Lewisburg, TN 37091-2018
Mailing address
1600 Jason Maxwell Blvd
Lewisburg, TN 37091-2018
Phone (931) 359-1197
Other providers in Lewisburg, TN
- Bedford County Health Department
- William Bell
- John Bernard Billingsley Jr.
- Bio-Medical Applications of Tennessee, Inc.
- Christopher B Bishop
- Marijo Cooper Bond
- George Bone
- Jessica E Boshers
- Carolyn J Brace
- Rebecca Brady
All providers in Lewisburg, TN · Behavior Technician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.