Provider Demographics
NPI:1396072849
Name:BEHAVIORAL HEALTH ASSOCIATES
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, BHA, P.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSEDPSYCHOLOGIST
Authorized Official - Phone:806-795-3911
Mailing Address - Street 1:3709 22ND PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1333
Mailing Address - Country:US
Mailing Address - Phone:806-795-3911
Mailing Address - Fax:806-795-2315
Practice Address - Street 1:3709 22ND PL
Practice Address - Street 2:SUITE C
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1333
Practice Address - Country:US
Practice Address - Phone:806-795-3911
Practice Address - Fax:806-795-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00332363-01Medicaid
TX00F81CMedicare PIN
TXR57763Medicare UPIN