Provider Demographics
NPI:1699401737
Name:NOT BOUND CONSULTING, LLC
Entity Type:Organization
Organization Name:NOT BOUND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:601-697-8392
Mailing Address - Street 1:422 WIGGINS LOOP RD STE B
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-9795
Mailing Address - Country:US
Mailing Address - Phone:601-697-8392
Mailing Address - Fax:
Practice Address - Street 1:422 WIGGINS LOOP RD STE B
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-9795
Practice Address - Country:US
Practice Address - Phone:601-697-8392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty