Provider Demographics
NPI:1831860915
Name:COMPREHENSIVE BEHAVIORAL HEALTH SUPPORT LLC
Entity type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTH SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RUSHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-880-0005
Mailing Address - Street 1:260 REITZ BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9220
Mailing Address - Country:US
Mailing Address - Phone:570-880-0005
Mailing Address - Fax:
Practice Address - Street 1:260 REITZ BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9220
Practice Address - Country:US
Practice Address - Phone:570-880-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty