Healthcare Provider Details

I. General information

NPI: 1780392662
Provider Name (Legal Business Name): BEYOND BEHAVIOR ABA AND LEARNING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 S 2ND ST
RICHMOND KY
40475-2102
US

IV. Provider business mailing address

PO BOX 3
RICHMOND KY
40476-0003
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-5505
  • Fax:
Mailing address:
  • Phone: 859-314-4158
  • 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 Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANA MCCARTHY
Title or Position: BCBA/OWNER
Credential: BCBA
Phone: 859-314-4158