Provider Demographics
NPI:1366928251
Name:BEHAVIOR CHANGE AND ASSOCIATES
Entity type:Organization
Organization Name:BEHAVIOR CHANGE AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCGLAMORY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:813-390-9482
Mailing Address - Street 1:160 E LAKE BRANTLEY DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4807
Mailing Address - Country:US
Mailing Address - Phone:321-972-6720
Mailing Address - Fax:321-295-7027
Practice Address - Street 1:160 E LAKE BRANTLEY DR
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4807
Practice Address - Country:US
Practice Address - Phone:321-972-6720
Practice Address - Fax:321-295-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-14
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11211921103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty