NPIMap

Organization Active NPI

Boost Behavioral Services LLC

  • Behavior Analyst
  • Beaufort, SC
National Provider Identifier
1912510074
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BOOST BEHAVIORAL SERVICES LLC
Doing business as
Boost Behavioral Services LLC
Practice address
14B Marshellen Dr
Beaufort, SC 29902-6900
Phone
(843) 400-4581
Fax
(843) 400-4024
NPI assigned
Aug 28, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Kelsey Freeze, BCBANPI 1972124410
Title
Owner
Phone
(912) 655-9431

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 Primary

Addresses

Primary practice location

14B Marshellen Dr
Beaufort, SC 29902-6900

Mailing address

174 James St
Beaufort, SC 29902-5324
Phone (912) 655-9431

Other names 1

  • Boost Behavioral Services LLC Doing business as

National Provider Directory

National Provider Directory

Locations

14B Marshellen Dr
Beaufort, SC 29902
Phone (843) 400-4581

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1912510074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 JAMES ST",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025324",
            "telephone_number": "912-655-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14B MARSHELLEN DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026900",
            "telephone_number": "843-400-4581",
            "fax_number": "843-400-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOST BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-655-9431",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boost Behavioral Services LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boost Behavioral Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.