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General NPI Number Information
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NPI Number | 1326791872
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Entity Type | Organization
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Legal Business Name | TBI BEHAVIORAL & RESIDENTIAL CONSULTANTS, LLC
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 34841 VETERANS PLZ
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City | WAYNE
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State | MI
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Zip | 48184-1733
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Country | US
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Telephone | 734-331-9532
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Fax | 313-292-9270
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Provider Business Mailing Address
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Address Line | 34841 VETERANS PLZ
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City | WAYNE
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State | MI
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Zip | 48184-1733
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Country | US
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Telephone | 734-331-9532
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | AARON KLASSEN
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Credential |
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Telephone | 734-331-9532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 103T00000X
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Taxonomy Name | Psychologist
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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