Provider Demographics
NPI:1801428123
Name:ENLIGHTEN BEHAVIORAL CONSULTATION, LLC
Entity type:Organization
Organization Name:ENLIGHTEN BEHAVIORAL CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAMETTRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:334-389-1344
Mailing Address - Street 1:305 RIVERVIEW CT
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36322
Mailing Address - Country:US
Mailing Address - Phone:334-389-1344
Mailing Address - Fax:334-635-0383
Practice Address - Street 1:305 RIVERVIEW CT
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36322
Practice Address - Country:US
Practice Address - Phone:334-389-1344
Practice Address - Fax:334-635-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty