Provider Demographics
NPI:1396407094
Name:LUNSFORD BEHAVIORAL CONSULTING & YOGA, LLC
Entity Type:Organization
Organization Name:LUNSFORD BEHAVIORAL CONSULTING & YOGA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:LUNSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MS, BCBA, LBA
Authorized Official - Phone:540-219-4440
Mailing Address - Street 1:104 BEATSON ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1419 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5423
Practice Address - Country:US
Practice Address - Phone:540-219-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-10
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health