BEHAVIOR HEALTH & WELLNESS CENTER, LLC – Early Intervention Provider Agency, NPI 1962736595
Early Intervention Provider Agency
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BEHAVIOR HEALTH & WELLNESS CENTER, LLC
330 Oxford St Ste 208B
Chula Vista, CA 919113119
Phone: (760) 278-3112
Fax: (888) 519-4656
Type: Location
1100 NW Loop 410 Ste 700
San Antonio, TX 782132258
Phone: (510) 776-3984
Fax: (888) 519-4656
Type: Location
3024 CONE MANOR LN
RALEIGH, NC 276136604
Phone: (510) 776-3984
Type: Mailing
2025, East Main Street, Shockoe Bottom, Richmond, Richmond City, Virginia, 23223, United States
SUITE 015
RICHMOND, VA 232237069
Phone: (510) 776-3984
Type: Location
11824 FISHING POINT DR STE B
NEWPORT NEWS, VA 236062679
Phone: (757) 599-0012
Fax: (888) 519-4656
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-09-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (588 days ago).
Enrollment records
2
Earliest due date
2024-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190103001505 | O | Clinic/Group Practice | CA | TBD |
| O20190904002621 | O | Clinic/Group Practice | VA | 2024-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91911)
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