Renew Behavior Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

RENEW BEHAVIOR SERVICES LLC

Practice address

524 N Elm St
Seymour, IN 47274-1902

Phone

(812) 569-4884

NPI assigned

Aug 23, 2019

Organization subpart

No

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

Authorized official

Name

Michelle Hickman, BCBA

Title

Owner/Bcba

Phone

(812) 569-4884

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1801443858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N ELM ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472741902",
            "telephone_number": "812-569-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 N ELM ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472741902",
            "telephone_number": "812-569-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW BEHAVIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "812-569-4884",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.