Provider Demographics
NPI:1083952279
Name:CARPE DIEM BEHAVIORAL CONSULTING
Entity Type:Organization
Organization Name:CARPE DIEM BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:281-543-5695
Mailing Address - Street 1:3602 LAKES OF KATY LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2485
Mailing Address - Country:US
Mailing Address - Phone:281-543-5695
Mailing Address - Fax:281-934-2040
Practice Address - Street 1:3602 LAKES OF KATY LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2485
Practice Address - Country:US
Practice Address - Phone:281-543-5695
Practice Address - Fax:281-934-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-10-6945103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty