Behavioranalystsupervisor

Behavior Analyst · Mount Shasta, CA

Organization Active NPI

NPI number 1790157154

Practice location

809 McCloud Ave
Mount Shasta, CA 96067-9603
Phone
(530) 227-2883

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NPI record

NPI
1790157154
Entity type
Organization (Type 2)
Enumeration date
October 26, 2015
Last updated
October 26, 2015
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Analyst Primary 103K00000X 1-13-12972 CA
School Psychologist 103TS0200X LEP3635 CA

Authorized official

Name
Mr. Kevin M Van Laeken, BCBA, LEP
Title
Owner/Operator
Phone
(530) 227-2883

About Behavioranalystsupervisor

Behavioranalystsupervisor is a healthcare organization registered in the NPI registry with the primary taxonomy Behavior Analyst (code 103K00000X). The practice location is 809 McCloud Ave, Mount Shasta, CA 96067-9603. The NPI number 1790157154 was assigned on October 26, 2015 and the record was last updated on October 26, 2015.

Behavioranalystsupervisor lists 2 licenses in the registry: #1-13-12972 (CA) for Behavior Analyst; #LEP3635 (CA) for School Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mr. Kevin M Van Laeken, BCBA, LEP, Owner/Operator.

Frequently asked questions

What is the NPI number of Behavioranalystsupervisor?

The NPI number is 1790157154.

What is the phone number of Behavioranalystsupervisor?

The phone number listed for the practice location is (530) 227-2883.

Where is Behavioranalystsupervisor located?

809 McCloud Ave, Mount Shasta, CA 96067-9603.

What is the taxonomy code for Behavioranalystsupervisor?

The primary taxonomy code is 103K00000X – Behavior Analyst; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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