Basic Information
| Provider Information | |||||||||
| NPI: | 1407911274 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BEHAVIORAL HEALTHCARE CONSULTANTS | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6 W NEWPORT RD | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175815255 | ||||||||
| FaxNumber: | 7175815259 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 W NEWPORT RD | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176272190 | ||||||||
| FaxNumber: | 7176270507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHEAFFER | ||||||||
| AuthorizedOfficialFirstName: | ROGER | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7175815255 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | 103TC2200X | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.