Healthcare Provider Details

I. General information

NPI: 1588271654
Provider Name (Legal Business Name): HELIX BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3785 BAKER LN STE 201
RENO NV
89509-5454
US

IV. Provider business mailing address

3785 BAKER LN STE 201
RENO NV
89509-5454
US

V. Phone/Fax

Practice location:
  • Phone: 209-505-0634
  • Fax:
Mailing address:
  • Phone: 209-505-0634
  • 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 Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENNETH JAMES KILLINGSWORTH
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: LBA, BCBA
Phone: 775-996-3890