Provider Demographics
NPI:1982406153
Name:EDIFY BEHAVIORAL APPLICATIONS LLC
Entity type:Organization
Organization Name:EDIFY BEHAVIORAL APPLICATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CHAIRMAN/CHIEF CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:YELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA,LBA
Authorized Official - Phone:810-614-7618
Mailing Address - Street 1:20220 GRATIOT RD
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:MI
Mailing Address - Zip Code:48637-9558
Mailing Address - Country:US
Mailing Address - Phone:810-614-7618
Mailing Address - Fax:
Practice Address - Street 1:405 S MISSION ST STE B
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2870
Practice Address - Country:US
Practice Address - Phone:810-614-7615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty