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NPI Code Detail

MEDICARE: NORTH STAR BEHAVIOR CONSULTANTS LLC

MEDICARE: NORTH STAR BEHAVIOR CONSULTANTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1457208811
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH STAR BEHAVIOR CONSULTANTS LLC
Provider Business Mailing Address
First Line : 13765 VINTAGE DR SW
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98367-7391
Country : US
Telephone Number : 253-970-2414
Fax Number : 360-207-3986
Provider Business Practice Location Address
First Line : 13765 VINTAGE DR SW
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98367-7391
Country : US
Telephone Number : 253-970-2414
Fax Number : 360-207-3986
Authorized Official
Title or Position : CERTIFIED BEHAVIORAL TECHNICIAN
Name : HAILEY JOAN ELIZABETH HANNA
Credential :
Telephone Number : 253-334-6151
Provider Enumeration Date : 03/13/2026
Last Update Date : 03/13/2026

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1609403468 — NORTH STAR BEHAVIOR CONSULTANTS, LLC
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13765 VINTAGE DR SW
PORT ORCHARD, WA
98367-7391
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Practice Fax: 360-207-3986

Directions to “NORTH STAR BEHAVIOR CONSULTANTS LLC ” Practice Location

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