Provider Demographics
NPI:1710742895
Name:CSG BEHAVIORAL CONSULTING
Entity Type:Organization
Organization Name:CSG BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:KONWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:814-598-9793
Mailing Address - Street 1:0-02 FAIR LAWN AVENUE #308
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:814-598-9793
Mailing Address - Fax:
Practice Address - Street 1:0-02 FAIR LAWN AVENUE #308
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:814-598-9793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health