=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841954591
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BISHOP ASPEN LEVY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2021
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 10TH AVE
-----------------------------------------------------
City | SHALIMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32579-1340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-362-6824
-----------------------------------------------------
Fax | 850-362-6826
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 259
-----------------------------------------------------
City | SHALIMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32579-0259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-362-6824
-----------------------------------------------------
Fax | 850-362-6826
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------