Provider Demographics
NPI:1598461584
Name:BEHAVIORAL HEALTHCARE CONSULTANT LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTHCARE CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ATU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-200-7202
Mailing Address - Street 1:8440 W LAKE MEAD BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7648
Mailing Address - Country:US
Mailing Address - Phone:786-200-7202
Mailing Address - Fax:
Practice Address - Street 1:8440 W LAKE MEAD BLVD STE 208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7648
Practice Address - Country:US
Practice Address - Phone:786-200-7202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1760025969Medicaid