Basic Information
| Provider Information | |||||||||
| NPI: | 1497485106 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADJUVENT BEHAVIORAL HEALTH INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11754 JOLLYVILLE RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787593948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123312700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11754 JOLLYVILLE RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787593948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123312700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2022 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MYERS | ||||||||
| AuthorizedOfficialFirstName: | JOSH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5123312700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD, LPC-S | ||||||||
| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.