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NPI Code Detail

MEDICARE: PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS, INC.

MEDICARE: PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1240022000OTHEROHMAGELLAN

General Provider Information

NPI Number : 1619172558
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS, INC.
Provider Business Mailing Address
First Line : 10200 ALLIANCE RD.
Second Line : SUITE 150
City : BLUE ASH
State : OH
Zip : 45242-4754
Country : US
Telephone Number : 513-891-0650
Fax Number : 513-891-2838
Provider Business Practice Location Address
First Line : 10200 ALLIANCE RD.
Second Line : SUITE 150
City : BLUE ASH
State : OH
Zip : 45242-4754
Country : US
Telephone Number : 513-891-0650
Fax Number : 513-891-2838
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : MR. DONALD SYKES JR.
Credential :
Telephone Number : 216-831-6611
Provider Enumeration Date : 06/20/2007
Last Update Date : 12/11/2017

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