Provider Demographics
NPI:1871119768
Name:PSYCHIATRIC NURSE CONSULTING & THERAPY, LLC
Entity type:Organization
Organization Name:PSYCHIATRIC NURSE CONSULTING & THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP
Authorized Official - Phone:360-588-4950
Mailing Address - Street 1:117 N 1ST ST STE 55
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2858
Mailing Address - Country:US
Mailing Address - Phone:360-588-4950
Mailing Address - Fax:360-873-8041
Practice Address - Street 1:117 N 1ST ST STE 55
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2858
Practice Address - Country:US
Practice Address - Phone:360-588-4950
Practice Address - Fax:360-873-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30001966OtherARNP WA STATE LICENSE
0124374OtherANCC CERTIFICATION
WA2146061Medicaid
WAMB4337487OtherDEA