Provider Demographics
NPI:1689851883
Name:BEHAVIOR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BEHAVIOR SOLUTIONS, LLC
Other - Org Name:NO OTHER ORGANIZATION NAME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CHITTUM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:423-341-6963
Mailing Address - Street 1:249 OLIVER EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6537
Mailing Address - Country:US
Mailing Address - Phone:423-341-6963
Mailing Address - Fax:423-753-6952
Practice Address - Street 1:249 OLIVER EDWARDS RD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-6537
Practice Address - Country:US
Practice Address - Phone:423-341-6963
Practice Address - Fax:423-753-6952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103K00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525233Medicaid