Provider Demographics
NPI:1407269368
Name:BEHAVIORAL HEALTH SPECIALISTS PLLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:423-442-2121
Mailing Address - Street 1:4023 HIGHWAY 411 UNIT A
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-1535
Mailing Address - Country:US
Mailing Address - Phone:423-442-2121
Mailing Address - Fax:423-545-9556
Practice Address - Street 1:465 ISBILL RD
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-2112
Practice Address - Country:US
Practice Address - Phone:423-442-3990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA1861363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty