Provider Demographics
NPI:1083507842
Name:ADAPTIVE BRAIN ACADEMY LLC
Entity type:Organization
Organization Name:ADAPTIVE BRAIN ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-361-1195
Mailing Address - Street 1:19 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-2105
Mailing Address - Country:US
Mailing Address - Phone:859-361-1195
Mailing Address - Fax:
Practice Address - Street 1:19 DEEPWOOD DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-2105
Practice Address - Country:US
Practice Address - Phone:859-361-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty