Provider Demographics
NPI:1841436649
Name:M & L BEHAVIORAL SERVICES INC.
Entity type:Organization
Organization Name:M & L BEHAVIORAL SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT M & L BEHAVIORAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:MARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-773-4337
Mailing Address - Street 1:102 MEADOW LARK WAY
Mailing Address - Street 2:
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692
Mailing Address - Country:US
Mailing Address - Phone:828-773-4337
Mailing Address - Fax:828-262-2974
Practice Address - Street 1:215 BOONE HEIGHTS DR.
Practice Address - Street 2:SUITE 205
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-773-4337
Practice Address - Fax:828-262-2974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TH0100X
NCNC2381103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2819648Medicare UPIN