Provider Demographics
NPI:1396872248
Name:BEHAVIOR CONSULTATION & THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:BEHAVIOR CONSULTATION & THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-GIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:317-858-8630
Mailing Address - Street 1:640 PATRICK PL STE B
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2214
Mailing Address - Country:US
Mailing Address - Phone:317-858-8630
Mailing Address - Fax:317-858-8715
Practice Address - Street 1:640 PATRICK PL STE B
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2214
Practice Address - Country:US
Practice Address - Phone:317-858-8630
Practice Address - Fax:317-858-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000160A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN183140AMedicare ID - Type Unspecified