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General NPI Number Information
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NPI Number | 1679215776
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Entity Type | Organization
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Legal Business Name | LEAF BEHAVIOR SUPPORT LLC
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Dates
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Enumeration Date | 04/09/2022
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Last Update Date | 04/09/2022
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Provider Practice Location Address
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Address Line | 3577 BRANNON DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6913
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Country | US
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Telephone | 757-971-1414
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Fax | 757-937-0287
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Provider Business Mailing Address
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Address Line | 3577 BRANNON DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6913
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Country | US
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Telephone | 757-971-1414
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Fax | 757-937-0287
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Authorized Official
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Title or Position | CEO
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Name | WHITNEY KING
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Credential | PBS-F
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Telephone | 757-971-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 224ZE0001X
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Taxonomy Name | Environmental Modification Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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