Provider Demographics
NPI:1710291802
Name:BEHAVIOR CONSULTATION AND PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:BEHAVIOR CONSULTATION AND PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR PSYCHOLOGIST/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORELEI
Authorized Official - Middle Name:
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:LPA
Authorized Official - Phone:919-605-6072
Mailing Address - Street 1:3851 DUNHAGAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6640
Mailing Address - Country:US
Mailing Address - Phone:252-751-0518
Mailing Address - Fax:
Practice Address - Street 1:3851 DUNHAGAN RD STE 102
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6640
Practice Address - Country:US
Practice Address - Phone:252-751-0518
Practice Address - Fax:252-751-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2274103T00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty