Healthcare Provider Details

I. General information

NPI: 1700343860
Provider Name (Legal Business Name): BRIGHT BEHAVIORS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1543 KINGSLEY AVE STE 6
ORANGE PARK FL
32073-4583
US

IV. Provider business mailing address

165 SCOTLAND YARD BLVD
SAINT JOHNS FL
32259-5913
US

V. Phone/Fax

Practice location:
  • Phone: 904-305-2069
  • Fax: 904-342-1430
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: EMILY JOHNSON
Title or Position: PRESIDENT
Credential: MA, BCBA
Phone: 904-305-2069