Healthcare Provider Details

I. General information

NPI: 1669103875
Provider Name (Legal Business Name): AWC BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2022
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 CAMINO GARDENS BLVD STE 201B
BOCA RATON FL
33432-5837
US

IV. Provider business mailing address

7618 MARGATE BLVD
MARGATE FL
33063-3352
US

V. Phone/Fax

Practice location:
  • Phone: 954-830-0915
  • Fax: 561-516-5529
Mailing address:
  • Phone: 954-274-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIE AUGUSTIN
Title or Position: CEO
Credential:
Phone: 954-274-1701