Provider Demographics
NPI:1265998652
Name:CHILDREN'S BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:CHILDREN'S BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RIVIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:573-883-6761
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-0683
Mailing Address - Country:US
Mailing Address - Phone:573-883-6761
Mailing Address - Fax:
Practice Address - Street 1:2240 COUNTY ROAD 1270
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-3393
Practice Address - Country:US
Practice Address - Phone:573-883-6761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1023439403Medicaid
MO1214365OtherANTHEM BCBS
MO1477738375Medicaid
MO1851986111Medicaid
MO730060041Medicaid