Provider Demographics
NPI: | 1962548834 |
---|---|
Name: | BEHAVIOR EDUCATION AND RESOURCE SPECIALISTS, INC. |
Entity type: | Organization |
Organization Name: | BEHAVIOR EDUCATION AND RESOURCE SPECIALISTS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | FINANCE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANDI |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | BENNETT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 252-537-6799 |
Mailing Address - Street 1: | 1609 E 10TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ROANOKE RAPIDS |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27870-4103 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 252-537-6799 |
Mailing Address - Fax: | 252-537-6793 |
Practice Address - Street 1: | 1609 E 10TH ST |
Practice Address - Street 2: | |
Practice Address - City: | ROANOKE RAPIDS |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27870-4103 |
Practice Address - Country: | US |
Practice Address - Phone: | 252-537-6799 |
Practice Address - Fax: | 252-537-6793 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-29 |
Last Update Date: | 2010-07-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101Y00000X, 101YM0800X, 101YP2500X, 103T00000X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TM1800X, 104100000X, 1041C0700X, 106H00000X, 251B00000X | ||
NC | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 018KK | Other | BCBS |
NC | 1215136494 | Other | HEALTH CHOICE |
NC | 1265540587 | Other | HEALTH CHOICE |
NE | 143A7 | Other | BCBS |
NC | 1519G | Other | HEALTH CHOICE |
NC | 152AW | Other | HEALTH CHOICE |
NC | 1972789550 | Medicaid | |
NC | 198608 | Other | MEDCOST |
NC | 6000693 | Medicaid | |
NC | 6103605 | Medicaid | |
NC | 6105177 | Medicaid | |
NC | 6106888 | Medicaid | |
NC | 1437309002 | Other | HEALTH CHOICE |
NC | 25960 | Other | BCBS |
NC | 8300824 | Medicaid | |
NC | 0136R | Other | BCBS |
NC | 1164624995 | Other | HEALTH CHOICE |
NC | 1245327535 | Other | HEALTH CHOICE |
NC | 1265540587 | Medicaid | |
NC | 152AV | Other | BCBS |
NC | 1730306937 | Medicaid | |
NC | 1801917679 | Medicaid | |
NC | 6005462 | Medicaid | |
NC | 0392C | Other | BCBS |
NC | 1043234305 | Medicaid | |
NC | 143V9 | Other | BCBS |
NC | 14410 | Other | BCBS |
NC | 1134245749 | Medicaid | |
NC | 1245327535 | Other | MEDCOST |
NC | 1476N | Other | BCBS |
NC | 3400151 | Medicaid | |
NC | 6003425 | Medicaid | |
NC | 1043234305 | Other | HEALTH CHOICE |
NC | 1205847324 | Medicaid | |
NC | 1215136494 | Medicaid | |
NC | 152AV | Other | HEALTH CHOICE |
NC | 1902119464 | Medicaid | |
NC | 195785 | Other | MEDCOST |
NC | 1164624995 | Medicaid | |
NC | 1437309002 | Medicaid | |
NC | 144P1 | Other | BCBS |
NC | 1871654285 | Other | HEALTH CHOICE |
NC | 1962548834 | Medicaid | |
NC | 8912147 | Medicaid | |
NC | 1134245749 | Other | HEALTH CHOICE |
NC | 1871654285 | Medicaid | |
NC | 198339 | Other | MEDCOST |
NC | 56162 | Other | MEDCOST |
NC | 6106370 | Medicaid | |
NC | 6107503 | Medicaid |