Healthcare Provider Details

I. General information

NPI: 1871893164
Provider Name (Legal Business Name): BEHAVIORAL HEALTH CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1499 LYNWOOD DR SUITE C
LANCASTER SC
29720-0963
US

IV. Provider business mailing address

PO BOX 61237
RALEIGH NC
27661-1237
US

V. Phone/Fax

Practice location:
  • Phone: 803-470-4908
  • Fax: 888-552-1363
Mailing address:
  • Phone: 803-470-4908
  • Fax: 888-552-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KENYA YOUNG
Title or Position: CEO
Credential:
Phone: 803-470-4908