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NPI Code Detail

MEDICARE: CAMEN BEHAVIORAL SERVICES, LLC

MEDICARE: CAMEN BEHAVIORAL SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2252Y00000XEarly Intervention Provider Agency014487800FL
3103K00000XBehavior Analyst

Other Identifiers

General Provider Information

NPI Number : 1174916563
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMEN BEHAVIORAL SERVICES, LLC
Provider Business Mailing Address
First Line : 5959 LAKE ELLENOR DR
Second Line :
City : ORLANDO
State : FL
Zip : 32809-4633
Country : US
Telephone Number : 321-972-4039
Fax Number : 321-445-9760
Provider Business Practice Location Address
First Line : 5959 LAKE ELLENOR DR
Second Line :
City : ORLANDO
State : FL
Zip : 32809-4633
Country : US
Telephone Number : 407-490-1453
Fax Number : 321-445-9760
Authorized Official
Title or Position : OWNER
Name : CLAIRE ALEXIS LOTTMAN
Credential : MS, BCBA
Telephone Number : 407-687-4439
Provider Enumeration Date : 03/10/2015
Last Update Date : 05/29/2025

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