Provider Demographics
NPI:1376699447
Name:BEHAVIORAL HEALTH CONSULTANTS
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:BENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-253-3739
Mailing Address - Street 1:PO BOX 1188
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1188
Mailing Address - Country:US
Mailing Address - Phone:352-253-3739
Mailing Address - Fax:352-253-3735
Practice Address - Street 1:3240 WATERMAN WAY
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5243
Practice Address - Country:US
Practice Address - Phone:352-253-3739
Practice Address - Fax:352-253-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77296OtherBLUE CROSS GROUP NUMBER
FLDE3694OtherRAILROAD MEDICARE
FLDE3694OtherRAILROAD MEDICARE