BOOST BEHAVIORAL SERVICES LLC (NPI# 1912510074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912510074 |
| Entity Type | Organization |
| Organization Name | BOOST BEHAVIORAL SERVICES LLC |
| Other Organization Name | BOOST BEHAVIORAL SERVICES LLC |
| Practice Address |
14b Marshellen Dr Beaufort SC 29902-6900 |
| Mailing Address |
174 James St Beaufort SC 29902-5324 |
| Practice Telephone | 8434004581 |
| Practice Fax Number | 8434004024 |
| Mailing Telephone | 9126559431 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | KELSEY FREEZE (OWNER) |
| Authorized Official Telephone | 9126559431 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Boost Behavioral Services LLC | Doing Business As Name - Organization |
| Street Address |
14B MARSHELLEN DR |
| City | BEAUFORT |
| State | SC |
| Zip Code | 29902-6900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1750992475 | Fayth Polite | Social Worker | 2210 Salem Drive East, Beaufort, SC 29902 | 2020-08-14 |
| 1417509530 | Andrew Grant Miner | Dentist | Naval Hospital Beaufort, 1 Pinckney Blvd., Fpo, AA 29902 | 2019-07-09 |
| 1376029777 | Edward Dela Fuente | Counselor | Coastal Empire Mental Health Center, 1050 Ribaut Road, Beaufort, SC 29902 | 2018-07-18 |
| 1114440419 | Kristin Webb | Registered Nurse | 607 Wilmington Street, Beaufort, SC 29902 | 2017-07-19 |
| 1326582081 | Annemarie Gierling Gault | Nurse Practitioner | Beaufort Memorial Medical Oncology Infusion Center, 989 Ribaut Rd, Ste 103, Beaufort, SC 29902 | 2016-12-14 |
| 1114396579 | Jacquelyn Faith Proulx | Dentist | 1 Pickney Blvd., Naval Hospital Beaufort, Beaufort, SC 29902 | 2015-09-16 |
| 1386028413 | Howard Family Dental - Beaufort, Pllc | Dentist | 35 Robert Smalls Pkwy, Beaufort, SC 29902 | 2015-07-18 |
| 1598018103 | Lisa Marie Johnson | Occupational Therapist | 9555 Ribaut Road, Beaufort Memorial Hospital, Beaufort, SC 29902 | 2012-10-19 |
| 1134497860 | Jeremy Michael Simmons | Pharmacist | 2127 Boundary Street, Suite 19, Beaufort, SC 29902 | 2011-12-08 |
| Find all providers in zip 29902 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588110456 | Jennifer Renee Cazales | Behavioral Analyst | 2201 Mossy Oaks Rd, A3, Beaufort, SC 29902-7600 | 2016-08-30 |
| 1154787265 | Kerianne Krause | Behavioral Analyst | 31 Professional Village Cir, Beaufort, SC 29907-1575 | 2016-01-05 |
| 1932541547 | Michelle Marie Alvarez | Behavioral Analyst | 2203 Salem Dr W, Beaufort, SC 29902-5225 | 2013-07-24 |
| 1649517962 | Megan E Lanzel | Behavioral Analyst | 17b Marshellen Dr, Beaufort, SC 29902-6900 | 2013-01-07 |
| 1962908269 | Haley Bray | Behavioral Analyst | 17b Marshellen Dr, Beaufort, SC 29902-6900 | 2018-04-04 |
| 1851892152 | Samantha Ruffner | Behavioral Analyst | 17b Marshellen Dr, Beaufort, SC 29902-6900 | 2018-02-22 |
| 1952816316 | Shelby Neeley | Behavioral Analyst | 17b Marshellen Dr, Beaufort, SC 29902-6900 | 2017-12-07 |
| 1033653027 | Deborah Sticco | Behavioral Analyst | 31 Professional Village Cir, Beaufort, SC 29907-1575 | 2016-12-09 |
| 1679921571 | Chelsea Tomaszewski | Behavioral Analyst | 17b Marshellen Dr, Beaufort, SC 29902-6900 | 2016-06-01 |
| 1487059861 | Jeffrey Violette | Behavioral Analyst | 1211 Harrington St, Beaufort, SC 29902-4179 | 2014-10-28 |
| Find all providers in BEAUFORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.