Organization
CHILDREN'S BEHAVIORAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA P RIVIELLO BCBA (OWNER)
(573) 883-6761
Entity
Organization
Contact information
Practice address
2240 COUNTY ROAD 1270, WILLOW SPRINGS, MO 65793-3393
(573) 883-6761
Mailing address
PO BOX 683, WILLOW SPRINGS, MO 65793-0683
(573) 883-6761
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023439403
—
MO
01
—
1214365
ANTHEM BCBS
MO
05
—
1477738375
—
MO
05
—
1851986111
—
MO
05
—
730060041
—
MO
Enumeration date
02/11/2019
Last updated
05/04/2023
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