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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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720548860
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 : 4727 W IRLO BRONSON MEMORIAL HWY
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-5326
Country : US
Telephone Number : 407-978-6085
Fax Number : 321-445-9760
Authorized Official
Title or Position : CEO
Name : CLAIRE ALEXIS LOTTMAN
Credential : BCBA
Telephone Number : 321-972-4039
Provider Enumeration Date : 03/24/2019
Last Update Date : 05/29/2025

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