Provider Demographics
NPI:1962650887
Name:PYXIS DBA BEHAVIORAL LINK
Entity Type:Organization
Organization Name:PYXIS DBA BEHAVIORAL LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:FORREST
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:919-875-9249
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-0429
Mailing Address - Country:US
Mailing Address - Phone:316-320-1354
Mailing Address - Fax:316-320-9602
Practice Address - Street 1:3737 BENSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7324
Practice Address - Country:US
Practice Address - Phone:919-875-9249
Practice Address - Fax:919-875-9259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006307Medicaid