Provider Demographics
NPI:1215779301
Name:LEAP BEHAVIOR CONSULTANTS LLC
Entity type:Organization
Organization Name:LEAP BEHAVIOR CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:LBA
Authorized Official - Phone:703-223-3647
Mailing Address - Street 1:3700 TOONE ST APT 2376
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5160
Mailing Address - Country:US
Mailing Address - Phone:703-223-3647
Mailing Address - Fax:
Practice Address - Street 1:3700 TOONE ST APT 2376
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5160
Practice Address - Country:US
Practice Address - Phone:703-223-3647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health