Provider Demographics
NPI:1780490516
Name:TG BEHAVIORAL HEALTH CONSULTANTS INC.
Entity type:Organization
Organization Name:TG BEHAVIORAL HEALTH CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KOMLANTSE
Authorized Official - Middle Name:MEDAKPE
Authorized Official - Last Name:GOSSOU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LBA
Authorized Official - Phone:514-243-1354
Mailing Address - Street 1:10 MILLER ST UNIT 2141
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-4083
Mailing Address - Country:US
Mailing Address - Phone:514-243-1354
Mailing Address - Fax:
Practice Address - Street 1:39 COURT ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2801
Practice Address - Country:US
Practice Address - Phone:514-243-1354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency