Healthcare Provider Details

I. General information

NPI: 1457408403
Provider Name (Legal Business Name): BEHAVIORAL CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 N BROADWAY STE 500
MILWAUKEE WI
53202-3612
US

IV. Provider business mailing address

757 N BROADWAY STE 500
MILWAUKEE WI
53202-3612
US

V. Phone/Fax

Practice location:
  • Phone: 414-271-5577
  • Fax: 414-271-6667
Mailing address:
  • Phone: 414-271-5577
  • Fax: 414-271-6667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JOHN COLLINS
Title or Position: CFO
Credential:
Phone: 414-271-5577