Basic Information
| Provider Information | |||||||||
| NPI: | 1356688923 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIOR AND LEARNING SOLUTIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8762 LOUISIANA ST | ||||||||
| Address2: | SUITE J | ||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464107191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2194720628 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8762 LOUISIANA ST | ||||||||
| Address2: | SUITE J | ||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464107191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2194720628 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2013 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | MCNEIL | ||||||||
| AuthorizedOfficialFirstName: | JILL | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2194720628 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | BCABA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0082557 | IN | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 1073892 | IL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | 1831348028 | 01 | IL | NPI | OTHER | 1013236645 | 01 | IN | NPI | OTHER |