MEDICARE: HEARTHSTONE BEHAVIORAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528946423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTHSTONE BEHAVIORAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	1528 HAVEN PL
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-4682
Country	:	US
Telephone Number	:	469-801-9732
Fax Number	:

Provider Business Practice Location Address
First Line	:	1528 HAVEN PL
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-4682
Country	:	US
Telephone Number	:	469-801-9732
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DYLAN GALBIATI
Credential	:	BCBA
Telephone Number	:	469-801-9732

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	09/08/2025

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