Healthcare Provider Details

I. General information

NPI: 1013694892
Provider Name (Legal Business Name): PIVOTAL BEHAVIOR CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 08/11/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 ECHO PASS RD
RENO NV
89521-3139
US

IV. Provider business mailing address

1905 ECHO PASS RD
RENO NV
89521-3139
US

V. Phone/Fax

Practice location:
  • Phone: 775-600-2068
  • Fax: 775-525-3887
Mailing address:
  • Phone: 775-600-2068
  • Fax: 775-525-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MCCARTNEY
Title or Position: OWNER
Credential: MS, BCBA
Phone: 201-248-8215