Michael Mong, PH.D., BCBA-D, LBA

Individual provider Active NPI Behavior Analyst · Pass Christian, MS

NPI 1972255826 · NPPES record last updated Jan 21, 2022

Key facts

NPI
1972255826
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
220004 (MS)
Practice address
213 Henderson Ave
Pass Christian, MS 39571-4309
Phone
(228) 300-8819
NPI assigned
Jan 21, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
220004MSMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 220004 MS Yes

Addresses

Primary practice location

213 Henderson Ave
Pass Christian, MS 39571-4309

Mailing address

213 Henderson Ave
Pass Christian, MS 39571-4309

Other providers in Pass Christian, MS

All providers in Pass Christian, MS · Behavior Analyst in Mississippi

Sources for this page

Verify at the official NPI Registry.