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Deactivated NPI 1578930939 Deactivated / Inactive NPI Female Practitioner

Carly Bazemore , BCBA

Behavior Analyst • Sumter, SC

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Carly Bazemore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 01, 2015
NPI Deactivation Date April 08, 2021
Total Practice Duration ~6 Years of Practice (2015 – 2021)

Professional Overview & Biography Verified Profile Summary

Carly Bazemore, BCBA was a registered Behavior Analyst practicing in Sumter, SC. Throughout an active medical career spanning 6 years, Carly Bazemore provided care at the practice location at 2580 LIN DO CT until profile deactivation on 2021-04-08.

Practice Location & Contact Primary Location

Practice Address

2580 Lin Do Ct

Sumter, SC 291501832

Telephone 8646312084
Fax 8039054431
Associated Practice Facility / Clinic
🏢 Gateway Counseling Services Facility NPI 1508278458

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Sumter, SC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
42 Specialists

Practicing in Sumter, SC (892 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License MO 2015027897

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Jeffrey Selman

Psychologist

NPI 1003151978
Lara Dabaibeh

Behavior Technician

NPI 1003305426
Lidya Seife

Behavior Technician

NPI 1013400415
Tiffany Rice-Moore

Behavior Technician

NPI 1013675107
Trina Jester

Behavior Technician

NPI 1023768488
Destiny Besu

Behavior Technician

NPI 1023976354

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 08, 2021

Record deactivated on April 08, 2021

NPI Profile Active August 19, 2016

NPI status registered as active in NPPES database

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Updated Practice Location August 19, 2016

Registered at 2580 LIN DO CT, SUMTER, SC 291501832 (Tel: 8646312084)

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Updated Business Mailing Address August 19, 2016

Registered at PO BOX 51322, BOWLING GREEN, KY 421025622 (Tel: 2707779283)

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Provider Name / Credentials Updated August 19, 2016

Recorded as CARLY BAZEMORE, BCBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2016

Behavior Analyst (License #2015027897 in MO)

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Initial NPI Registration & Enumeration September 01, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578930939
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 01, 2015
Last Update: August 19, 2016
Deactivation Date: April 08, 2021

Mailing Address

Po Box 51322

Bowling Green, KY 421025622

Phone: 2707779283

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.