Provider Demographics
NPI:1548976640
Name:POSITIVE BEHAVIOR CHANGE, LLC
Entity type:Organization
Organization Name:POSITIVE BEHAVIOR CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:917-526-2384
Mailing Address - Street 1:422 VFW RD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-6302
Mailing Address - Country:US
Mailing Address - Phone:917-526-2384
Mailing Address - Fax:
Practice Address - Street 1:422 VFW RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-6302
Practice Address - Country:US
Practice Address - Phone:917-526-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty