Provider Demographics
NPI:1831130046
Name:BEHAVIORAL HEALTH SOLUTIONS, PA
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SOLUTIONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERSH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-419-0524
Mailing Address - Street 1:1415 HIGHWAY 54 WEST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5597
Mailing Address - Country:US
Mailing Address - Phone:919-419-0524
Mailing Address - Fax:919-419-9651
Practice Address - Street 1:1415 HIGHWAY 54 WEST
Practice Address - Street 2:SUITE 111
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5597
Practice Address - Country:US
Practice Address - Phone:919-419-0524
Practice Address - Fax:919-419-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2693103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000480Medicaid