Provider Demographics
NPI:1215194923
Name:ADVANCED BEHAVIORAL SOLUTIONS
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:SHARA
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:847-413-9001
Mailing Address - Street 1:2060 EAST ALGONQUIN ROAD
Mailing Address - Street 2:SUITE 720
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-496-4693
Mailing Address - Fax:847-496-7027
Practice Address - Street 1:2060 EAST ALGONQUIN ROAD
Practice Address - Street 2:SUITE 720
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-496-4693
Practice Address - Fax:847-496-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005929103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty