Healthcare Provider Details

I. General information

NPI: 1639036072
Provider Name (Legal Business Name): BEHAVIOR CHANGE SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 MAJESTIC CIR
VIRGINIA BEACH VA
23452-1709
US

IV. Provider business mailing address

6126 SAINT DENIS ST
CORPUS CHRISTI TX
78414-6120
US

V. Phone/Fax

Practice location:
  • Phone: 361-236-2169
  • Fax:
Mailing address:
  • Phone: 361-236-2169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SUJEY PELIKAN
Title or Position: CLINICAL DIRECTOR
Credential: BCBA, LBA
Phone: 361-236-2169