Provider Demographics
NPI:1255768099
Name:STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING & MANAGEMENT
Entity type:Organization
Organization Name:STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING & MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:SHAW
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:919-951-8919
Mailing Address - Street 1:20082 LONG
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7339
Mailing Address - Country:US
Mailing Address - Phone:919-951-8919
Mailing Address - Fax:919-967-9965
Practice Address - Street 1:3708 LYCKAN PKWY
Practice Address - Street 2:201
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2586
Practice Address - Country:US
Practice Address - Phone:919-951-8919
Practice Address - Fax:919-967-9965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty