Provider Demographics
NPI:1659363976
Name:BEHAVIOR CONSULTATION SERVICES
Entity Type:Organization
Organization Name:BEHAVIOR CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-GIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-858-8630
Mailing Address - Street 1:PO BOX 1110
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5110
Mailing Address - Country:US
Mailing Address - Phone:317-858-8630
Mailing Address - Fax:317-858-8715
Practice Address - Street 1:39 MOTIF BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1017
Practice Address - Country:US
Practice Address - Phone:317-858-8630
Practice Address - Fax:317-858-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Not Answered174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN219430Medicare ID - Type Unspecified
IN183140Medicare ID - Type Unspecified