Healthcare Provider Details
I. General information
NPI: 1962558015
Provider Name (Legal Business Name): BEHAVIORAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2007
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33316 HEAVENLY WAY STE 203
OCEAN VIEW DE
19970-3473
US
IV. Provider business mailing address
33316 HEAVENLY WAY STE 203
OCEAN VIEW DE
19970-3473
US
V. Phone/Fax
- Phone: 302-567-1695
- Fax: 302-616-3934
- Phone: 302-567-1695
- Fax: 302-616-3934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY636 |
| License Number State | HI |
VIII. Authorized Official
Name:
MELINDA
ANN
KOHR
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 302-567-1695