MEDICARE: BEHAVIORAL INTERVENTIONS, TRAINING & EVALUATIONS, 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
1	174400000X	Specialist	0904002771	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902839277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL INTERVENTIONS, TRAINING & EVALUATIONS, INC.

Provider Business Mailing Address
First Line	:	2108 THOROUGHGOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-4015
Country	:	US
Telephone Number	:	757-416-5325
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 THOROUGHGOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-4015
Country	:	US
Telephone Number	:	757-416-5325
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MS. LISA B. SEDJAT
Credential	:	L.C.S.W
Telephone Number	:	757-416-5325

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/13/2010

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