Provider Demographics
NPI:1861851008
Name:CHILD & ADOLESCENT PSYCHIATRY CONSULTING LLC
Entity Type:Organization
Organization Name:CHILD & ADOLESCENT PSYCHIATRY CONSULTING LLC
Other - Org Name:BEHREND PSYCHOLOGY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-423-2030
Mailing Address - Street 1:3930 8TH ST S STE 101
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-6511
Mailing Address - Country:US
Mailing Address - Phone:715-423-2030
Mailing Address - Fax:715-423-2032
Practice Address - Street 1:3930 8TH ST S STE 101
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-6511
Practice Address - Country:US
Practice Address - Phone:715-423-2030
Practice Address - Fax:715-423-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2981261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)