Provider Demographics
NPI:1679335301
Name:WESTLAKE BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:WESTLAKE BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAQ
Authorized Official - Middle Name:MCKENZIE
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:915-203-6342
Mailing Address - Street 1:3709 MEREDITH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-2020
Mailing Address - Country:US
Mailing Address - Phone:915-203-6342
Mailing Address - Fax:
Practice Address - Street 1:3709 MEREDITH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-2020
Practice Address - Country:US
Practice Address - Phone:915-203-6342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty