Provider Demographics
NPI:1285812834
Name:BEHAVIORAL HEALTH AND EDUCATION SPECIALISTS INC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH AND EDUCATION SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUCKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:815-609-1544
Mailing Address - Street 1:14953 S VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5804
Mailing Address - Country:US
Mailing Address - Phone:815-609-1544
Mailing Address - Fax:815-609-1670
Practice Address - Street 1:14953 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5804
Practice Address - Country:US
Practice Address - Phone:815-609-1544
Practice Address - Fax:815-609-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007613101YP2500X
101YP2500X, 103TC0700X, 2084P0800X, 2084P0804X
IL071-006519103TC0700X
IL071-006097103TC0700X
IL071-006914103TC0700X
IL071-007551103TC0700X
IL071-006216103TC0700X
IL071.001938103TC0700X
IL149.0148681041C0700X
IL036-1005192084P0800X
IL036.0852902084P0800X
IL036.1074302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty