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General NPI Number Information
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NPI Number | 1427367036
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL INTERVENTION GROUP LLC
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 920 DANNON VW SW SUITE 3204
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City | ATLANTA
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State | GA
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Zip | 30331-2157
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Country | US
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Telephone | 404-914-2788
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Fax | 404-952-1909
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Provider Business Mailing Address
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Address Line | PO BOX 78292
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City | ATLANTA
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State | GA
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Zip | 30357-2292
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Country | US
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Telephone | 404-914-2788
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Fax | 404-952-1909
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY R HILL
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Credential | LPC
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Telephone | 404-914-2788
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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 | LPC005316
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License Number State | GA
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