Provider Demographics
NPI:1558779355
Name:NEUROBEHAVIORAL CONSULTANTS, LLC
Entity Type:Organization
Organization Name:NEUROBEHAVIORAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWIER-VOSNOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-550-3043
Mailing Address - Street 1:6296 RUCKER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4888
Mailing Address - Country:US
Mailing Address - Phone:317-550-3043
Mailing Address - Fax:317-886-4823
Practice Address - Street 1:4356 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1932
Practice Address - Country:US
Practice Address - Phone:317-550-3043
Practice Address - Fax:317-886-4823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042634A103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty