=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447269410
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEHAVIORAL HEALTH CONSULTANTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2006
-----------------------------------------------------
Last Update Date | 04/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2319 WHITNEY AVE STE 5D
-----------------------------------------------------
City | HAMDEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06518-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-288-3554
-----------------------------------------------------
Fax | 203-248-3690
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2319 WHITNEY AVE STE 5D
-----------------------------------------------------
City | HAMDEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06518-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-288-3554
-----------------------------------------------------
Fax | 203-248-3690
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING PARTNER
-----------------------------------------------------
Name | DR. MARK KIRSCHNER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 203-288-3554
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------