BEHAVIOR EDUCATION AND RESOURCE SPECIALIST, INC.

Provider Demographics

• NPI: 1730226721
• Name: BEHAVIOR EDUCATION AND RESOURCE SPECIALIST, INC.
• Entity type: Organization
• Organization Name: BEHAVIOR EDUCATION AND RESOURCE SPECIALIST, INC.
• Authorized Official - Title/Position: FINANCE MANAGER
• Authorized Official - First Name: SANDI
• Authorized Official - Last Name: BENNETT
• Authorized Official - Phone: 252-537-6799
• Mailing Address - Street 1: 1609 E 10TH ST
• Mailing Address - City: ROANOKE RAPIDS
• Mailing Address - State: NC
• Mailing Address - Zip Code: 27870-4103
• Mailing Address - Country: US
• Mailing Address - Phone: 252-537-6799
• Mailing Address - Fax: 252-537-6793
• Practice Address - Street 1: 1609 E 10TH ST
• Practice Address - City: ROANOKE RAPIDS
• Practice Address - State: NC
• Practice Address - Zip Code: 27870-4103
• Practice Address - Country: US
• Practice Address - Phone: 252-537-6799
• Practice Address - Fax: 252-537-6793
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-31
• Last Update Date: 2010-04-12

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)
No	261QM0850X	Ambulatory Health Care Facilities	Clinic/Center	Adult Mental Health
No	261QM0855X	Ambulatory Health Care Facilities	Clinic/Center	Adolescent and Children Mental Health

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	0392C	Other	BCBS
NC	12147	Other	BCBS
NC	143V9	Other	BCBS
NC	1476N	Other	BCBS
NC	1649386632	Other	HEALTHCHOICE
NC	194769	Other	MEDCOST
NC	6107503	Medicaid
NC	135V6	Other	BCBS
NC	144P1	Other	BCBS
NC	1649386632	Other	PHYSICIAN FAMILY PRACTICE
NC	1972789550	Medicaid
NC	2850999A	Other	MEDICARE
NC	6103605	Medicaid
NC	6105177	Medicaid
NC	6106888	Medicaid
NC	890136R	Medicaid
NC	1265452270	Other	HEALTHCHOICE
NC	25960	Other	BCBS
NC	6106370	Medicaid
NC	14410	Other	BCBS
NC	2821267	Other	MEDICARE
NC	56162	Other	MEDCOST
NC	5902141	Medicaid
NC	1447314073	Medicaid
NC	198339	Other	MEDCOST
NC	89135V6	Medicaid
NC	018KK	Other	BCBS
NC	1215136494	Medicaid
NC	1245327535	Other	MEDCOST
NC	1265452270	Other	PSYCHIATRY AND NEUROLOGY
NC	0136R	Other	BCBS
NC	2823719	Other	MEDICARE
NC	6000693	Medicaid
NC	6107268	Medicaid
NC	1164529640	Medicaid
NC	1265518823	Medicaid
NC	1508850983	Other	PHYSICIAN ASSISTANT
NC	195785	Other	MEDCOST
NC	1982697595	Other	PHYSICIAN
NC	198608	Other	MEDCOST
NC	232093	Other	MEDICARE
NC	890257L	Medicaid
NC	8921983	Medicaid
NC	198608	Other	MEDCOST
NC	1215136494	Medicaid