Provider Demographics
NPI:1205451820
Name:BEHAVIOR TRANSFORMATION SERVICES LLC
Entity type:Organization
Organization Name:BEHAVIOR TRANSFORMATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:DONOGHUE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-766-5308
Mailing Address - Street 1:3200 W LIBERTY RD STE G
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9183
Mailing Address - Country:US
Mailing Address - Phone:248-766-5308
Mailing Address - Fax:
Practice Address - Street 1:3200 W LIBERTY RD STE G
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9183
Practice Address - Country:US
Practice Address - Phone:248-766-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty