Provider Demographics
NPI:1306551809
Name:EMPATH BEHAVIORAL CONSULTING, LLC
Entity type:Organization
Organization Name:EMPATH BEHAVIORAL CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SPANGENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-960-5366
Mailing Address - Street 1:25 1/2 SEVILLA ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-3550
Mailing Address - Country:US
Mailing Address - Phone:941-960-5366
Mailing Address - Fax:
Practice Address - Street 1:25 1/2 SEVILLA ST
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-3550
Practice Address - Country:US
Practice Address - Phone:941-960-5366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty