MEDICARE: BEHAVIOR CONSULTANTS, INC.

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
1	103T00000X	Psychologist	20040892A	IN

General Provider Information

NPI Number	:	1598821605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR CONSULTANTS, INC.

Provider Business Mailing Address
First Line	:	2506 WILLOWBROOK PKWY STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1548
Country	:	US
Telephone Number	:	317-254-0435
Fax Number	:	317-252-2622

Provider Business Practice Location Address
First Line	:	2506 WILLOWBROOK PKWY STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1548
Country	:	US
Telephone Number	:	317-254-0435
Fax Number	:	317-252-2622

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DALLAS E. MULVANEY
Credential	:	PHD, HSPP
Telephone Number	:	317-254-0435

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	08/22/2020

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