Provider Demographics
NPI:1700418142
Name:BEHAVIOR THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:BEHAVIOR THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHATRECE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:770-276-9156
Mailing Address - Street 1:4744 N ROYAL ATLANTA DR STE A
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-3820
Mailing Address - Country:US
Mailing Address - Phone:678-609-7541
Mailing Address - Fax:
Practice Address - Street 1:4744 N ROYAL ATLANTA DR STE A
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-3820
Practice Address - Country:US
Practice Address - Phone:770-276-9156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty