Provider Demographics
NPI:1912372988
Name:BEHAVIORAL PSYCHOTHERAPISTS AND CONSULTANTS, INCORPORATED
Entity Type:Organization
Organization Name:BEHAVIORAL PSYCHOTHERAPISTS AND CONSULTANTS, INCORPORATED
Other - Org Name:BPAC, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW
Authorized Official - Phone:636-220-1611
Mailing Address - Street 1:884 WOODSMILL ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3567
Mailing Address - Country:US
Mailing Address - Phone:636-220-1611
Mailing Address - Fax:636-220-1615
Practice Address - Street 1:884 WOODSMILL ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-3567
Practice Address - Country:US
Practice Address - Phone:636-220-1611
Practice Address - Fax:636-220-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty