Healthcare Provider Details

I. General information

NPI: 1689851883
Provider Name (Legal Business Name): BEHAVIOR SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 OLIVER EDWARDS RD
JONESBOROUGH TN
37659-6537
US

IV. Provider business mailing address

249 OLIVER EDWARDS RD
JONESBOROUGH TN
37659-6537
US

V. Phone/Fax

Practice location:
  • Phone: 423-341-6963
  • Fax: 423-753-6952
Mailing address:
  • Phone: 423-341-6963
  • Fax: 423-753-6952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM ROBERT CHITTUM
Title or Position: DIRECTOR
Credential: M.S., BCBA
Phone: 423-341-6963