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General NPI Number Information
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NPI Number | 1063165280
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Entity Type | Organization
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Legal Business Name | THERABEHAVIOR & CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 12300 S SHORE BLVD STE 218
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City | WELLINGTON
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State | FL
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Zip | 33414-6509
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Country | US
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Telephone | 561-880-7948
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Fax |
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Provider Business Mailing Address
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Address Line | 12214 CORDIA DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-6049
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Country | US
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Telephone | 561-880-7948
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NELSON COLLIN
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Credential |
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Telephone | 561-880-7948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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