Provider Demographics
NPI:1710663646
Name:ADVANCED BEHAVIORAL HEALTH CONSULTS , LLC
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH CONSULTS , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:AFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:786-541-5472
Mailing Address - Street 1:3350 SW 148 AVE 110
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027
Mailing Address - Country:US
Mailing Address - Phone:786-541-5472
Mailing Address - Fax:
Practice Address - Street 1:3350 SW 148 AVE 110
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:786-541-5472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty