Provider Demographics
NPI:1154010866
Name:MGC BEHAVIORAL CONSULTING
Entity type:Organization
Organization Name:MGC BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:MARIKATE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABASE
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, BCBA
Authorized Official - Phone:860-280-4712
Mailing Address - Street 1:8 POND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:CT
Mailing Address - Zip Code:06043-7557
Mailing Address - Country:US
Mailing Address - Phone:860-280-4712
Mailing Address - Fax:
Practice Address - Street 1:8 POND VIEW RD
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:CT
Practice Address - Zip Code:06043-7557
Practice Address - Country:US
Practice Address - Phone:860-280-4712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center