Provider Demographics
NPI:1649560376
Name:ALLIANT BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:ALLIANT BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:501-205-0703
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-0280
Mailing Address - Country:US
Mailing Address - Phone:501-205-0703
Mailing Address - Fax:501-778-4889
Practice Address - Street 1:1511 W SEVIER ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-2437
Practice Address - Country:US
Practice Address - Phone:501-205-0703
Practice Address - Fax:501-778-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10-25P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty