Provider Demographics
NPI:1891433181
Name:ORSENO BEHAVIORAL
Entity Type:Organization
Organization Name:ORSENO BEHAVIORAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ORSENO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-541-5548
Mailing Address - Street 1:15723 OLD ORCHARD CT UNIT 1N
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3565
Mailing Address - Country:US
Mailing Address - Phone:708-541-5548
Mailing Address - Fax:
Practice Address - Street 1:15723 OLD ORCHARD CT UNIT 1N
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3565
Practice Address - Country:US
Practice Address - Phone:708-541-5548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty