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Organization

BEHAVIORAL SUPPORT & NURSING SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGIE MATTINGLY (MANAGER PROVIDER ENROLLMENT)
(502) 381-3579
Entity
Organization

Contact information

Practice address
1600 NE LOOP 410 STE 105, SAN ANTONIO, TX 78209-1612
(210) 246-2334
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-5186
(502) 394-2100

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
103K00000X
Behavior Analyst
1041C0700X
Clinical Social Worker

Other

Enumeration date
04/02/2020
Last updated
04/12/2022
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