Provider Demographics
NPI:1942375605
Name:BEHAVIORAL RESEARCH ASSESSMENT AND TRAINING SERVICES
Entity Type:Organization
Organization Name:BEHAVIORAL RESEARCH ASSESSMENT AND TRAINING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SHEPERIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:662-648-9829
Mailing Address - Street 1:PO BOX 9727
Mailing Address - Street 2:
Mailing Address - City:MISSISSIPPI STATE
Mailing Address - State:MS
Mailing Address - Zip Code:39762-9727
Mailing Address - Country:US
Mailing Address - Phone:662-648-9829
Mailing Address - Fax:662-325-3263
Practice Address - Street 1:112B W GILLESPIE ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3206
Practice Address - Country:US
Practice Address - Phone:662-648-9829
Practice Address - Fax:662-325-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS832251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health