Provider Demographics
NPI:1477867059
Name:ASSOCIATED BEHAVIOR CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ASSOCIATED BEHAVIOR CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR ADMIN SVCS
Authorized Official - Prefix:DR
Authorized Official - First Name:JM
Authorized Official - Middle Name:
Authorized Official - Last Name:EVOSEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, BCBA
Authorized Official - Phone:760-537-0212
Mailing Address - Street 1:901 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:SUITE A201
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6757
Mailing Address - Country:US
Mailing Address - Phone:760-537-0212
Mailing Address - Fax:760-778-7709
Practice Address - Street 1:901 E TAHQUITZ CANYON WAY
Practice Address - Street 2:SUITE A201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6757
Practice Address - Country:US
Practice Address - Phone:760-537-0212
Practice Address - Fax:760-778-7709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1106767103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty