Provider Demographics
NPI:1639658891
Name:MCG BEHAVIORAL CONSULTING
Entity Type:Organization
Organization Name:MCG BEHAVIORAL CONSULTING
Other - Org Name:BEHAVIORAL CONSULTANTS OF THE PALM BEACHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:MARIKATE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-280-4712
Mailing Address - Street 1:4514 MAIN ST APT 1024
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5362
Mailing Address - Country:US
Mailing Address - Phone:860-280-4712
Mailing Address - Fax:
Practice Address - Street 1:4514 MAIN ST APT 1024
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5362
Practice Address - Country:US
Practice Address - Phone:860-280-4712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty