Provider Demographics
NPI:1376910729
Name:BEHAVIORAL CONSULTING FOR AUTISM, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL CONSULTING FOR AUTISM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, BCBA
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:DEMIS
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-619-1200
Mailing Address - Street 1:4039 MASONBORO LOOP RD
Mailing Address - Street 2:SUITE 1-0
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-3683
Mailing Address - Country:US
Mailing Address - Phone:910-619-1200
Mailing Address - Fax:910-395-1777
Practice Address - Street 1:4039 MASONBORO LOOP RD
Practice Address - Street 2:SUITE 1-0
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-3683
Practice Address - Country:US
Practice Address - Phone:910-619-1200
Practice Address - Fax:910-395-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty