Creative Minds Behavior Services, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-07-3620

Legal business name

CREATIVE MINDS BEHAVIOR SERVICES, LLC

Practice address

4636 Lebanon Pike # 167
Hermitage, TN 37076-1316

Phone

(615) 513-7183

Fax

(615) 777-3210

NPI assigned

Jul 23, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Rasoul Mokhtari, MS, BCBANPI 1093040347

Title

Behavior Analyst

Phone

(615) 513-7183

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rasoul Mokhtari, M.S. BCBA

  • Developmental Therapist
  • Hermitage, TN
  • NPI 1093040347
  NPD Authorized official

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1831574565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 LEBANON PIKE # 167",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761316",
            "telephone_number": "615-513-7183",
            "fax_number": "615-777-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 LEBANON PIKE # 167",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761316",
            "telephone_number": "615-513-7183",
            "fax_number": "615-777-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE MINDS BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "MOKHTARI",
        "authorized_official_first_name": "RASOUL",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "615-513-7183",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-07-3620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald E. Cox, DDS
• Caprice M Craig, CNP
• John Craig, D.D.S.
• Jeremy M. Crain, PHARM.D.
• Grace Cravens, OD
• Wendy Thompson Crick, RPH
• Crossroads Treatment Centers of Tennessee, PC
• Crossroads Urgent Care, PLLC
• Donald S Crumbo, M.D
• Mackenzie Cryder

• All providers in Hermitage, TN
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.