| Headway Aba LLC | |
|
104 S White St Ste 208 Wake Forest NC 27587-2773 | |
| (980) 222-4486 | |
| Not Available |
| Full Name | Headway Aba LLC |
|---|---|
| Speciality | Psychologist |
| Location | 104 S White St Ste 208, Wake Forest, North Carolina |
| Authorized Official Name and Position | Ben Beitel (OWNER) |
| Authorized Official Contact | 9802224486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headway Aba LLC 104 S White St Ste 208 Wake Forest NC 27587-2773 Ph: (980) 222-4486 | Headway Aba LLC 104 S White St Ste 208 Wake Forest NC 27587-2773 Ph: (980) 222-4486 |
| NPI Number | 1114702321 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114702321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (NU) | Primary |
| 103K00000X | Behavior Analyst | (NU) | Secondary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
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