Healthcare Provider Details

I. General information

NPI: 1437000718
Provider Name (Legal Business Name): BEHAVIOR BLUEPRINT THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 UNION AVENUE EXT
MEMPHIS TN
38112-4426
US

IV. Provider business mailing address

2670 UNION AVENUE EXT
MEMPHIS TN
38112-4426
US

V. Phone/Fax

Practice location:
  • Phone: 901-238-5814
  • Fax:
Mailing address:
  • Phone: 901-238-5814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CHAUNTELL TROUTMAN
Title or Position: DIRECTOR & BCBA
Credential: BCBA LBA
Phone: 901-238-5814