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Organization

BRIGHT PATHS BEHAVIORAL THERAPY LLC

Active
Other names
Bright Paths Behavioral Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA MOCK (BCBA)
(631) 901-3711
Entity
Organization

Contact information

Practice address
11747 JEFFERSON AVE STE 3H, NEWPORT NEWS, VA 23606-4403
(631) 901-3711
Mailing address
3236 ST JAMES PARK, WILLIAMSBURG, VA 23188-1467

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1841842564
TRICARE
VA
Enumeration date
07/19/2022
Last updated
01/08/2025
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