Healthcare Provider Details

I. General information

NPI: 1487538732
Provider Name (Legal Business Name): TRIBECK THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 W 3RD AVE
ALBANY GA
31707-3647
US

IV. Provider business mailing address

PO BOX 51293
ALBANY GA
31703-1293
US

V. Phone/Fax

Practice location:
  • Phone: 229-255-0066
  • Fax: 229-439-9553
Mailing address:
  • Phone: 229-255-0066
  • Fax: 229-439-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATRINA M WILBURN-BECKHOM
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 229-255-0066