Healthcare Provider Details

I. General information

NPI: 1366959769
Provider Name (Legal Business Name): BEHAVIORAL HEALTH CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 NORTH ACADEMY BLVD, SUITE 3
COLORADO SPRINGS CO
80917
US

IV. Provider business mailing address

3210 NORTH ACADEMY BLVD., SUITE 3
COLORADO SPRINGS CO
80917
US

V. Phone/Fax

Practice location:
  • Phone: 719-330-2258
  • Fax: 719-531-5712
Mailing address:
  • Phone: 719-330-2258
  • Fax: 719-531-5712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL LEE GRABILL
Title or Position: PRESIDENT
Credential: MED, LPC, LAC
Phone: 719-330-2258