Provider Demographics
NPI:1154608537
Name:ADVANCED BEHAVIOR & CLINICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIOR & CLINICAL SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:ARVANS-FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:269-762-2076
Mailing Address - Street 1:10399 DOUBLE R BLVD # 102
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5991
Mailing Address - Country:US
Mailing Address - Phone:269-762-2076
Mailing Address - Fax:719-452-3461
Practice Address - Street 1:10399 DOUBLE R BLVD # 102
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5991
Practice Address - Country:US
Practice Address - Phone:269-762-2076
Practice Address - Fax:719-452-3461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3518103K00000X, 103TC0700X
NV1-08-4677103K00000X
NVPY0658103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty