Provider Demographics
NPI:1407106909
Name:SMITH GROUP BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:SMITH GROUP BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:HAYS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:334-332-9077
Mailing Address - Street 1:2006 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6074
Mailing Address - Country:US
Mailing Address - Phone:334-332-9077
Mailing Address - Fax:334-363-0740
Practice Address - Street 1:2006 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6074
Practice Address - Country:US
Practice Address - Phone:334-332-9077
Practice Address - Fax:334-363-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty