Provider Demographics
NPI:1770046880
Name:NEXT PHASE BEHAVIORAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:NEXT PHASE BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:706-905-5525
Mailing Address - Street 1:5820 VETERANS PKWY STE 303
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3452
Mailing Address - Country:US
Mailing Address - Phone:706-905-5525
Mailing Address - Fax:706-956-5441
Practice Address - Street 1:6003 VETERANS PKWY STE 206
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6200
Practice Address - Country:US
Practice Address - Phone:706-905-5525
Practice Address - Fax:706-956-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty