MEDICARE: BEHAVIORAL INTERVENTION AND CONSULTING

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	1-16-22536	OH

General Provider Information

NPI Number	:	1578916607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL INTERVENTION AND CONSULTING

Provider Business Mailing Address
First Line	:	3322 ERIE AVE
Second Line	:	SUITE 4
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1655
Country	:	US
Telephone Number	:	513-492-2374
Fax Number	:

Provider Business Practice Location Address
First Line	:	3322 ERIE AVE
Second Line	:	SUITE 4
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1655
Country	:	US
Telephone Number	:	513-492-2374
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LEAD BCBA
Name	:	CARA BROWN
Credential	:	BCBA
Telephone Number	:	513-492-2374

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	07/13/2016

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