Provider Demographics
NPI:1447074786
Name:WESTERN BEHAVIORAL ASSOCIATES, PC
Entity type:Organization
Organization Name:WESTERN BEHAVIORAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MBA
Authorized Official - Phone:847-542-2997
Mailing Address - Street 1:4465 E PARADISE VILLAGE PKWY S APT 1129
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7763
Mailing Address - Country:US
Mailing Address - Phone:847-542-2997
Mailing Address - Fax:
Practice Address - Street 1:4465 E PARADISE VILLAGE PKWY S APT 1129
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7763
Practice Address - Country:US
Practice Address - Phone:847-542-2997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty