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General NPI Number Information
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NPI Number | 1730770884
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Entity Type | Organization
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Legal Business Name | CHILDREN'S BEHAVIORAL THERAPY
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 710 S 8TH ST STE B
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City | BEAUMONT
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State | TX
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Zip | 77701-4634
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Country | US
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Telephone | 409-299-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 6305 HIGHPOINT AVE
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City | BEAUMONT
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State | TX
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Zip | 77708-3651
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Country | US
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Telephone | 915-799-8722
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | CYNTHIA COSTA
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Credential | BCBA
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Telephone | 915-799-8722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 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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