=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912741471
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APRICOTT SC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2024
-----------------------------------------------------
Last Update Date | 08/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6650 RIVERS AVE STE 100
-----------------------------------------------------
City | NORTH CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29406-4809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-200-6102
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12 BAYVIEW AVE UNIT 29
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11559-4002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | J H
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-200-6102
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------