Provider Demographics
NPI:1275701955
Name:JAMES P. GARDEPE
Entity Type:Organization
Organization Name:JAMES P. GARDEPE
Other - Org Name:APPLIED BEHAVIOR CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:GARDEPE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-882-2004
Mailing Address - Street 1:915 WILLOWBROOK DR SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-3262
Mailing Address - Country:US
Mailing Address - Phone:256-882-2004
Mailing Address - Fax:
Practice Address - Street 1:915 WILLOWBROOK DR SE
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-3262
Practice Address - Country:US
Practice Address - Phone:256-882-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL523103T00000X, 103TB0200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51074448GAROtherBC/BS OF ALABAMA
AL529400650Medicaid