Provider Demographics
NPI:1275085706
Name:BEHAVIORAL HEALTH CONSULTANTS, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:VAUGHN-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:334-201-5052
Mailing Address - Street 1:39293 PLYMOUTH RD
Mailing Address - Street 2:SUITE 109A
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39293 PLYMOUTH RD
Practice Address - Street 2:SUITE 109A
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1060
Practice Address - Country:US
Practice Address - Phone:334-201-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801089011251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health