Provider Demographics
NPI:1588872816
Name:BATHERSON CONSULTANTS, LLC
Entity type:Organization
Organization Name:BATHERSON CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:W
Authorized Official - Last Name:BATHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MALLP
Authorized Official - Phone:810-494-7111
Mailing Address - Street 1:822 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-2303
Mailing Address - Country:US
Mailing Address - Phone:810-494-7111
Mailing Address - Fax:810-494-7116
Practice Address - Street 1:822 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2303
Practice Address - Country:US
Practice Address - Phone:810-494-7111
Practice Address - Fax:810-494-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006275103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty