Provider Demographics
NPI:1992254882
Name:SR PLUS BEHAVIOR CONSULTANTS, INC.
Entity type:Organization
Organization Name:SR PLUS BEHAVIOR CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCULTHORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-763-5469
Mailing Address - Street 1:730 MAIN ST # 230
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3030
Mailing Address - Country:US
Mailing Address - Phone:813-763-5469
Mailing Address - Fax:813-441-8362
Practice Address - Street 1:3600 PITCHERS PL
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-6798
Practice Address - Country:US
Practice Address - Phone:813-763-5469
Practice Address - Fax:813-441-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty