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Organization
COMPREHENSIVE BEHAVIORAL SERVICES, LLC
Active
Organization
COMPREHENSIVE BEHAVIORAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAYLE BEVILL-DADA MS, LMHC (PRESIDENT/COO)
(260) 492-5500
Entity
Organization
Contact information
Practice address
2809 E DUPONT RD, FORT WAYNE, IN 46825-1668
(260) 492-5500
(260) 492-5530
Mailing address
2809 E DUPONT RD, FORT WAYNE, IN 46825-1668
(260) 492-5500
(260) 492-5530
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001423A
IN
103TC1900X
Counseling Psychologist
2004070712A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100332280
—
IN
05
—
1023221207
—
IN
05
—
1053488197
—
IN
Enumeration date
05/07/2007
Last updated
06/26/2012
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