MEDICARE: BEHAVIORAL EMPOWERMENT COACHING, PLLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710577044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL EMPOWERMENT COACHING, PLLC

Provider Business Mailing Address
First Line	:	834 WESTOVER AVE APT 6
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-1525
Country	:	US
Telephone Number	:	757-639-0512
Fax Number	:	757-401-4377

Provider Business Practice Location Address
First Line	:	834 WESTOVER AVE APT 6
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-1525
Country	:	US
Telephone Number	:	757-639-0512
Fax Number	:	757-401-4377

Authorized Official
Title or Position	:	BCBA/FOUNDER
Name	:	MS. CHANELLE DOCTOR
Credential	:	M.ED, BCBA, LBA, RDT
Telephone Number	:	757-639-0512

Provider Enumeration Date	:	01/20/2021
Last Update Date	:	10/23/2025

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