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General NPI Number Information
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NPI Number | 1972173227
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL INTERVENTION THERAPY SERVICES LLC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 3212 OLEANDER AVE
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City | FORT PIERCE
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State | FL
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Zip | 34982-6426
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Country | US
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Telephone | 772-233-6446
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Fax | 772-264-3990
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Provider Business Mailing Address
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Address Line | 4273 SW MCCLELLEN ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-6135
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Country | US
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Telephone | 561-398-5309
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. SHANNON S PRINCE
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Credential | BCBA
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Telephone | 561-398-5309
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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 | 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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