| Positive Behavior Consulting, Llc | |
|
5401 Blue Holly Circle Glen Allen VA 23060-6539 | |
| (804) 221-8745 | |
| (866) 864-6286 |
| Full Name | Positive Behavior Consulting, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5401 Blue Holly Circle, Glen Allen, Virginia |
| Authorized Official Name and Position | Justin Lee Creech (BEHAVIOR ANALYST) |
| Authorized Official Contact | 8044026134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Behavior Consulting, Llc P.o. Box 3767 Glen Allen VA 23058-3767 Ph: (804) 221-8745 | Positive Behavior Consulting, Llc 5401 Blue Holly Circle Glen Allen VA 23060-6539 Ph: (804) 221-8745 |
| NPI Number | 1619122348 |
|---|---|
| Provider Enumeration Date | 11/21/2008 |
| Last Update Date | 09/14/2020 |
| Certification Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619122348 | NPI | - | NPPES |
| 010297796 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 109 (Virginia) | Primary |
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