Provider Demographics
NPI:1114732013
Name:CONCERTO BEHAVIOR THERAPY
Entity type:Organization
Organization Name:CONCERTO BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARSAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:215-913-2011
Mailing Address - Street 1:500 LAS COLINAS DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8094
Mailing Address - Country:US
Mailing Address - Phone:215-913-2011
Mailing Address - Fax:
Practice Address - Street 1:500 LAS COLINAS DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-8094
Practice Address - Country:US
Practice Address - Phone:215-913-2011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty