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Contact Information

PROACTIVE BEHAVIOR THERAPY
12573 CHILLICOTHE ROAD
CHESTERLAND, OH44026
 Phone: 440-313-8636
 Fax: 855-960-0149
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Technician

106S00000X
 

Assistant Behavior Analyst

106E00000X
 

Behavior Analyst

103K00000X
Indicates primary specialty

NPI Profile & details for PROACTIVE BEHAVIOR THERAPY

NPI # 1912686197
LBN Legal business name PROACTIVE BEHAVIOR THERAPY
Authorized official LEAH GONGOLA - (FOUNDER AND CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/14/2023
Last updated 07/14/2023 - About 3 years ago
Identifiers
OH Medicaid 0477305
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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