Provider Demographics
NPI:1083952568
Name:ENGAGED BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ENGAGED BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FAULKNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-231-1001
Mailing Address - Street 1:20 BATTERY PARK AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2720
Mailing Address - Country:US
Mailing Address - Phone:828-231-1001
Mailing Address - Fax:828-658-3995
Practice Address - Street 1:20 BATTERY PARK AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2720
Practice Address - Country:US
Practice Address - Phone:828-231-1001
Practice Address - Fax:828-658-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty