MEDICARE: KOMMUNISON BEHAVIORAL SUPPORT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1285508259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOMMUNISON BEHAVIORAL SUPPORT LLC

Provider Business Mailing Address
First Line	:	1099 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-0002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-0002
Country	:	US
Telephone Number	:	610-470-1296
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIOR ANALYST
Name	:	DR. ARTHUR GLENN DOWDY IV
Credential	:	PHD, BCBA-D
Telephone Number	:	610-470-1296

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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