Healthcare Provider Details

I. General information

NPI: 1497502504
Provider Name (Legal Business Name): NATIONAL BEHAVIORAL THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S WENONA ST STE 195
BAY CITY MI
48706-8820
US

IV. Provider business mailing address

835 LOUISA ST STE 205
LANSING MI
48911-5200
US

V. Phone/Fax

Practice location:
  • Phone: 713-448-9918
  • Fax: 313-583-7002
Mailing address:
  • Phone: 313-497-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. FARZANA ISLAM
Title or Position: CEO
Credential: M.ED. QBHP
Phone: 713-448-9918