Provider Demographics
NPI:1811615800
Name:AVENUE BEHAVIOR CONSULTING
Entity type:Organization
Organization Name:AVENUE BEHAVIOR CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-EO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA LBA
Authorized Official - Phone:210-323-8601
Mailing Address - Street 1:14317 POTRANCO RD
Mailing Address - Street 2:STE 205, #327
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-7126
Mailing Address - Country:US
Mailing Address - Phone:210-323-8601
Mailing Address - Fax:888-215-1365
Practice Address - Street 1:14317 POTRANCO RD
Practice Address - Street 2:STE 205, #327
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-7126
Practice Address - Country:US
Practice Address - Phone:210-323-8601
Practice Address - Fax:888-215-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty