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General NPI Number Information
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NPI Number | 1245550250
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL CONSULTANTS LLC
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 11206 WOODTOWN RD
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City | GALENA
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State | OH
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Zip | 43021-9638
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Country | US
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Telephone | 614-923-2585
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Fax | 614-923-2585
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Provider Business Mailing Address
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Address Line | 11206 WOODTOWN RD
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City | GALENA
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State | OH
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Zip | 43021-9638
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Country | US
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Telephone | 614-923-2585
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Fax | 614-923-2585
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ROBERT DALTON
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Credential | PH.D.
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Telephone | 614-975-1675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 6606
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 6606
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 6606
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6606
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License Number State | OH
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