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1487545430 NPI number — BEHAVIOR BLUEPRINT

NPI Number: 1487545430
Health Care Provider/Practitioner: BEHAVIOR BLUEPRINT

Information about “1487545430” NPI (BEHAVIOR BLUEPRINT) exists in 1487545430 in HTML format HTML  |  1487545430 in plain Text format TXT  |  1487545430 in PDF (Portable Document Format) PDF  |  1487545430 in an XML format XML  formats.

NPI Number : 1487545430 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487545430",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BEHAVIOR BLUEPRINT",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2670 UNION",
    "SecondLineMailingAddress": "822",
    "MailingAddressCityName": "MEMPHIS",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38112",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "901-238-5814",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2670 UNION",
    "SecondLinePracticeLocationAddress": "822",
    "PracticeLocationAddressCityName": "MEMPHIS",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38112",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "901-238-5814",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/09/2025",
    "LastUpdateDate": "07/09/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "TROUTMAN",
    "AuthorizedOfficialFirstName": "CHAUNTELL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CLINICAL DIRECTOR/ OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "BCBA MS LBA TN",
    "AuthorizedOfficialTelephoneNumber": "901-238-5814",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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