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Contact Information

BEHAVIORAL MEDICINE, LLC
3585 VINEVILLE AVE
MACON, GA31204-1872
 Phone: 478-476-0403
 Fax: 478-476-9533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BEHAVIORAL MEDICINE, LLC

NPI Number 1457534513
LBN Legal business name BEHAVIORAL MEDICINE, LLC
Authorized official CHRISTOPHER TILLITSKI - (PSYCHOLOGIST/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/12/2007
Last updated 12/12/2007 - About 18 years ago
Identifiers
GA License # 001724
GA Other 68BBDDL MEDICARE ID
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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