Provider Demographics
NPI:1598230864
Name:BUILDING BEHAVIORS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BUILDING BEHAVIORS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-810-8277
Mailing Address - Street 1:PO BOX 4752
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-4752
Mailing Address - Country:US
Mailing Address - Phone:228-424-3427
Mailing Address - Fax:601-510-9400
Practice Address - Street 1:240 EISENHOWER DR STE C2
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-3649
Practice Address - Country:US
Practice Address - Phone:228-424-3427
Practice Address - Fax:601-510-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02933778Medicaid