Provider Demographics
NPI:1508349036
Name:BEAR BEHAVIOR CONSULTING, LLC
Entity Type:Organization
Organization Name:BEAR BEHAVIOR CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK GUERCIO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:618-946-2068
Mailing Address - Street 1:214 HARTCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2053
Mailing Address - Country:US
Mailing Address - Phone:618-946-2068
Mailing Address - Fax:888-638-4615
Practice Address - Street 1:214 HARTCOURT AVE
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2053
Practice Address - Country:US
Practice Address - Phone:618-946-2068
Practice Address - Fax:888-638-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty