Basic Information
| Provider Information | |||||||||
| NPI: | 1548780083 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POSEY | ||||||||
| FirstName: | LOGAN | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 786 OMAHA DR | ||||||||
| Address2: | |||||||||
| City: | BROADWAY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275058160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4095044133 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5948 FISHER RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283045751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104012870 | ||||||||
| FaxNumber: | 9194676777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-15-01317 | N | 103K00000X | 1-19-35253 | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.