=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710577044
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEHAVIORAL EMPOWERMENT COACHING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2021
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 834 WESTOVER AVE APT 6
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23507-1525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-639-0512
-----------------------------------------------------
Fax | 757-401-4377
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 834 WESTOVER AVE APT 6
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23507-1525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-639-0512
-----------------------------------------------------
Fax | 757-401-4377
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BCBA/FOUNDER
-----------------------------------------------------
Name | MS. CHANELLE DOCTOR
-----------------------------------------------------
Credential | M.ED, BCBA, LBA, RDT
-----------------------------------------------------
Telephone | 757-639-0512
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------