Provider Demographics
NPI:1902199326
Name:BEHAVIORAL HEALTH CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:860-673-0145
Mailing Address - Street 1:46 W AVON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3679
Mailing Address - Country:US
Mailing Address - Phone:860-673-0145
Mailing Address - Fax:860-673-1255
Practice Address - Street 1:46 W AVON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3679
Practice Address - Country:US
Practice Address - Phone:860-673-0145
Practice Address - Fax:860-673-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT101YP2500X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty