Provider Demographics
NPI:1235408089
Name:BEHAVIORAL RESEARCH SPECIALISTS, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL RESEARCH SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-524-0000
Mailing Address - Street 1:115 W. CALIFORNIA BLVD
Mailing Address - Street 2:#194
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:818-524-0000
Mailing Address - Fax:818-255-7744
Practice Address - Street 1:230 N. MARYLAND AVE
Practice Address - Street 2:#309
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206
Practice Address - Country:US
Practice Address - Phone:818-524-0000
Practice Address - Fax:818-255-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty