Provider Demographics
NPI:1508434259
Name:BHCONSULTATION, LLC
Entity Type:Organization
Organization Name:BHCONSULTATION, LLC
Other - Org Name:BHCONSULTATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HEDGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:740-475-0488
Mailing Address - Street 1:3527 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:43155-9648
Mailing Address - Country:US
Mailing Address - Phone:740-243-0740
Mailing Address - Fax:
Practice Address - Street 1:624 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3903
Practice Address - Country:US
Practice Address - Phone:740-475-0488
Practice Address - Fax:740-409-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0891816Medicaid