Healthcare Provider Details

I. General information

NPI: 1487518007
Provider Name (Legal Business Name): ACTION BEHAVIOR CENTERS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S 20TH AVE
BRIGHTON CO
80601-3703
US

IV. Provider business mailing address

6300 BEE CAVES RD BLDG 2-100
AUSTIN TX
78746-5842
US

V. Phone/Fax

Practice location:
  • Phone: 970-305-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA GOMEZ
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 512-774-3702