Provider Demographics
NPI:1639856966
Name:PRECISION BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:PRECISION BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:847-504-6172
Mailing Address - Street 1:993 E WIMPOLE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1947
Mailing Address - Country:US
Mailing Address - Phone:480-250-2062
Mailing Address - Fax:833-520-1551
Practice Address - Street 1:993 E WIMPOLE AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1947
Practice Address - Country:US
Practice Address - Phone:480-250-2062
Practice Address - Fax:833-520-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty