Provider Demographics
NPI:1134410905
Name:ADVANCED BEHAVIOR CONSULTANTS
Entity type:Organization
Organization Name:ADVANCED BEHAVIOR CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE-MARIE
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-449-0063
Mailing Address - Street 1:3441 FORT CAMPBELL BLVD STE F3
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-6684
Mailing Address - Country:US
Mailing Address - Phone:931-449-0063
Mailing Address - Fax:931-896-2737
Practice Address - Street 1:3441 FORT CAMPBELL BLVD STE F3
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-6684
Practice Address - Country:US
Practice Address - Phone:931-449-0063
Practice Address - Fax:931-896-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty