Provider Demographics
NPI:1396075685
Name:BEHAVIORAL CONSULTING SERVICES
Entity type:Organization
Organization Name:BEHAVIORAL CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:703-232-9691
Mailing Address - Street 1:3961 BLYSDALE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-7445
Mailing Address - Country:US
Mailing Address - Phone:703-232-9691
Mailing Address - Fax:703-730-2039
Practice Address - Street 1:3961 BLYSDALE LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7445
Practice Address - Country:US
Practice Address - Phone:703-232-9691
Practice Address - Fax:703-730-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-07-2281251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health