Healthcare Provider Details

I. General information

NPI: 1508434259
Provider Name (Legal Business Name): BHCONSULTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E MAIN ST
LANCASTER OH
43130-3903
US

IV. Provider business mailing address

3527 PARADISE RD
SUGAR GROVE OH
43155-9648
US

V. Phone/Fax

Practice location:
  • Phone: 740-475-0488
  • Fax: 740-409-6976
Mailing address:
  • Phone: 740-243-0740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY ALAN HEDGES
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 740-475-0488