Provider Demographics
NPI:1285932335
Name:BEHAVIORAL SCIENCE INSTITUTE, INC.
Entity type:Organization
Organization Name:BEHAVIORAL SCIENCE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR.THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:314-607-2573
Mailing Address - Street 1:12685 DORSETT RD
Mailing Address - Street 2:#339
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2100
Mailing Address - Country:US
Mailing Address - Phone:314-607-2573
Mailing Address - Fax:
Practice Address - Street 1:141 MARKET PLACE
Practice Address - Street 2:SUITE 206
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208
Practice Address - Country:US
Practice Address - Phone:314-607-2573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-13
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty