CMS-1500 Box 24J / 33a • NPI
1881255412
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
103K00000X
Licensed & Credentialed Behavior Analyst
Box 32 Service Location & ZIP+4
20100 S WESTERN AVE # A4, TORRANCE, CA, 90501-1307
✓ 9-Digit EDI 837 ZIP+4 (90501-1307)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1881255412 (4 BEHAVIOR CHANGE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1881255412 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 4 BEHAVIOR CHANGE |
| Plain-English Specialty | Licensed & Credentialed Behavior Analyst NUCC Code: 103K00000X (Behavior Analyst) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 20100 S WESTERN AVE # A4, TORRANCE, CA, 90501-1307 |
| Practice Telephone / Fax | Tel: (800) 701-6592 |
| Administrative Mailing Address | 20100 S WESTERN AVE # A4, TORRANCE, CA, 90501-1307 |
| Enumeration & Last Sync | Enumerated: 2019-06-25 | CMS Record Updated: 2020-10-13 |
| Authorized Official | LORI BRUMMEL (President) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (103K00000X)
What Does Taxonomy Code 103K00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103K00000X translates to:
"Licensed & Credentialed Behavior Analyst"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (4 BEHAVIOR CHANGE)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YM0800X — Counselor, Mental HealthPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
101YS0200X — Counselor, SchoolPlain English: Licensed & Credentialed Counselor, School | State: N/A | License: Verified | Primary: Secondary |
106S00000X — Behavior TechnicianPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Technician | State: N/A | License: Verified | Primary: Secondary |
103TS0200X — Psychologist, SchoolPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, School | State: N/A | License: Verified | Primary: Secondary |
106E00000X — Assistant Behavior AnalystPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst | State: N/A | License: Verified | Primary: Secondary |
103K00000X — Behavior AnalystPlain English: Licensed & Credentialed Behavior Analyst | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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