Provider Demographics
NPI:1871473132
Name:BRANDYWINE CENTER FOR AUTISM, LLC
Entity type:Organization
Organization Name:BRANDYWINE CENTER FOR AUTISM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VALPRESIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPPM
Authorized Official - Phone:302-327-9215
Mailing Address - Street 1:510 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2100
Mailing Address - Country:US
Mailing Address - Phone:302-327-9215
Mailing Address - Fax:302-348-9028
Practice Address - Street 1:1035 W STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1146
Practice Address - Country:US
Practice Address - Phone:302-327-9215
Practice Address - Fax:320-348-9028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRANDYWINE CENTER FOR AUTISM, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty