Provider Demographics
NPI:1871326322
Name:BEHAVIOR CONNECT LLC
Entity type:Organization
Organization Name:BEHAVIOR CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:BREONIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:704-718-4169
Mailing Address - Street 1:907 MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-5220
Mailing Address - Country:US
Mailing Address - Phone:704-718-4169
Mailing Address - Fax:
Practice Address - Street 1:7412 HUNTERS HORN DR
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-5208
Practice Address - Country:US
Practice Address - Phone:704-718-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst