Provider Demographics
NPI:1316714165
Name:BRASS BEHAVIOR CONSULTATION LLC
Entity type:Organization
Organization Name:BRASS BEHAVIOR CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRASS
Authorized Official - Suffix:
Authorized Official - Credentials:PBSF
Authorized Official - Phone:443-752-2628
Mailing Address - Street 1:1044 29TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-4202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1044 29TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-4202
Practice Address - Country:US
Practice Address - Phone:443-752-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health