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General NPI Number Information
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NPI Number | 1306079223
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Entity Type | Organization
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Legal Business Name | BURLINGTON BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 565 MILWAUKEE AVE SUITE 3C
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City | BURLINGTON
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State | WI
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Zip | 53105-1254
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Country | US
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Telephone | 262-757-0016
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Fax | 262-757-0018
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Provider Business Mailing Address
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Address Line | 565 MILWAUKEE AVE SUITE 3C
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City | BURLINGTON
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State | WI
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Zip | 53105-1254
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Country | US
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Telephone | 262-757-0016
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Fax | 262-757-0018
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. DON CROWDER
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Credential | PH.D
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Telephone | 262-757-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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