Provider Demographics
NPI:1508984857
Name:BEACON BEHAVIORAL CONSULTANTS, INC
Entity Type:Organization
Organization Name:BEACON BEHAVIORAL CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELKER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:615-310-6151
Mailing Address - Street 1:1139 WOODRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4510
Mailing Address - Country:US
Mailing Address - Phone:615-310-6151
Mailing Address - Fax:615-288-4943
Practice Address - Street 1:1139 WOODRIDGE PL
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4510
Practice Address - Country:US
Practice Address - Phone:615-310-6151
Practice Address - Fax:615-288-4943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health