Healthcare Provider Details

I. General information

NPI: 1568793982
Provider Name (Legal Business Name): CHRISTIAN BEHAVIORAL HEALTH SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2010
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 NW EXECUTIVE CENTER DR STE 2270
BOCA RATON FL
33431-8579
US

IV. Provider business mailing address

2385 NW EXECUTIVE CENTER DR STE 100 SUITE 100
BOCA RATON FL
33431-8510
US

V. Phone/Fax

Practice location:
  • Phone: 954-889-0311
  • Fax: 954-962-9594
Mailing address:
  • Phone: 954-889-0311
  • Fax: 954-962-9594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. DENISE A CANCHOLA
Title or Position: PRESIDENT
Credential: ARNP
Phone: 954-962-9090