MEDICARE: BRIGHTER STRIDES ABA NC 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	:	1891453510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER STRIDES ABA NC LLC

Provider Business Mailing Address
First Line	:	5265 PARKWAY PLAZA BLVD STE 125
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-0363
Country	:	US
Telephone Number	:	980-317-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	5265 PARKWAY PLAZA BLVD STE 125
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-0363
Country	:	US
Telephone Number	:	980-317-8260
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	LEAH KURTZ
Credential	:
Telephone Number	:	410-609-6357

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	06/16/2026

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