Provider Demographics
NPI:1851871206
Name:BEHAVIORAL CONSULTING OF TAMPA BAY, INC
Entity Type:Organization
Organization Name:BEHAVIORAL CONSULTING OF TAMPA BAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:813-814-2000
Mailing Address - Street 1:14497 DALE MABRY HIGHWAY
Mailing Address - Street 2:STE 115N
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2023
Mailing Address - Country:US
Mailing Address - Phone:813-814-2000
Mailing Address - Fax:813-814-2004
Practice Address - Street 1:14497 DALE MABRY HIGHWAY
Practice Address - Street 2:STE 115N
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2023
Practice Address - Country:US
Practice Address - Phone:813-814-2000
Practice Address - Fax:813-814-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty