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General NPI Number Information
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NPI Number | 1659516607
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH CONSULTANST, LLP
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 923 N 2ND ST
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City | PIEDMONT
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State | MO
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Zip | 63957-1160
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Country | US
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Telephone | 573-223-7062
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Fax |
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Provider Business Mailing Address
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Address Line | 923 N 2ND ST
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City | PIEDMONT
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State | MO
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Zip | 63957-1160
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Country | US
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Telephone | 573-223-7062
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Fax |
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | MS. SUSAN DENISE STEPHENS
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Credential | LPC
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Telephone | 573-776-4778
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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 | 2008035710
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License Number State | MO
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