Provider Demographics
NPI:1962706200
Name:BEHAVIORAL HEALTH DIAGNOSTICS, PLLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH DIAGNOSTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:T
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-430-4436
Mailing Address - Street 1:203 LOY DR
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2243
Mailing Address - Country:US
Mailing Address - Phone:919-496-4935
Mailing Address - Fax:
Practice Address - Street 1:510 DABNEY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:252-430-4436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty