=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518698158
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEYOND THE VIEW AUTISM SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2022
-----------------------------------------------------
Last Update Date | 06/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3524 VICTORIA ST
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30337-2508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-987-3288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1564 ARBOR PLACE DR
-----------------------------------------------------
City | MORROW
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30260-4187
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-987-3288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
-----------------------------------------------------
Name | DANIELLE STRICKLAND
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-987-3288
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------