Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Pediatric Therapy, LLC

Organization Behavior Analyst · NPI 1669303772

Providence Pediatric Therapy, LLC is a Behavior Analyst in Brandon, Mississippi. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

109 Ofc Park DR Ste B&c
Brandon, MS 39042-2403
Phone: (769) 257-1416
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1669303772
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sydney Bearden — Owner · (601) 213-3112
NPI enumeratedMay 27, 2026
Last updated in NPPESJune 22, 2026
Certification dateJune 22, 2026
Mailing address109 Office Park Dr Ste B&C, Brandon, MS 39042-2403

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