Healthcare Provider Details

I. General information

NPI: 1851210579
Provider Name (Legal Business Name): PLEASANT VALLEY BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E9176A PLEASANT VALLEY RD
BARABOO WI
53913-9489
US

IV. Provider business mailing address

E9176A PLEASANT VALLEY RD
BARABOO WI
53913-9489
US

V. Phone/Fax

Practice location:
  • Phone: 608-393-7718
  • Fax:
Mailing address:
  • Phone: 608-393-7718
  • 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: KAYLEE HICKEY
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential:
Phone: 608-393-7718