Provider Demographics
NPI:1033660436
Name:CARNOUSTIE SOLUTIONS GROUP LLC
Entity Type:Organization
Organization Name:CARNOUSTIE SOLUTIONS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVELHIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-655-9163
Mailing Address - Street 1:1416 EAGLES NEST TRL
Mailing Address - Street 2:
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-7527
Mailing Address - Country:US
Mailing Address - Phone:484-655-9163
Mailing Address - Fax:817-329-3312
Practice Address - Street 1:1416 EAGLES NEST TRL
Practice Address - Street 2:
Practice Address - City:KRUM
Practice Address - State:TX
Practice Address - Zip Code:76249-7527
Practice Address - Country:US
Practice Address - Phone:484-655-9163
Practice Address - Fax:817-329-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty