Provider Demographics
NPI:1497380307
Name:MARKLAND BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:MARKLAND BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNEE
Authorized Official - Middle Name:MAE KAY
Authorized Official - Last Name:MARKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:423-331-9923
Mailing Address - Street 1:230 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1206
Mailing Address - Country:US
Mailing Address - Phone:423-331-9923
Mailing Address - Fax:
Practice Address - Street 1:230 1ST ST
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1206
Practice Address - Country:US
Practice Address - Phone:423-331-9923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty