Provider Demographics
NPI:1356165450
Name:BRIGHT MINDS CONSULTING LLC
Entity type:Organization
Organization Name:BRIGHT MINDS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAENZIGER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:815-319-3555
Mailing Address - Street 1:29854 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60145-8538
Mailing Address - Country:US
Mailing Address - Phone:815-319-3555
Mailing Address - Fax:
Practice Address - Street 1:29854 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:IL
Practice Address - Zip Code:60145-8538
Practice Address - Country:US
Practice Address - Phone:815-319-3555
Practice Address - Fax:815-895-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty