Provider Demographics
NPI:1952016602
Name:ADVANCED BEHAVIOR CONSULTING
Entity Type:Organization
Organization Name:ADVANCED BEHAVIOR CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA-LBA
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-LBA
Authorized Official - Phone:602-393-8574
Mailing Address - Street 1:726 E MICHELLE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-6037
Mailing Address - Country:US
Mailing Address - Phone:602-393-8574
Mailing Address - Fax:602-297-6929
Practice Address - Street 1:726 E MICHELLE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6037
Practice Address - Country:US
Practice Address - Phone:602-393-8574
Practice Address - Fax:602-297-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1811590896OtherCOMMERCIAL/MEDICAID