Healthcare Provider Details
I. General information
NPI: 1871417378
Provider Name (Legal Business Name): IN VIA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2820 ARMSTRONG AVE
CLERMONT FL
34714-8100
US
IV. Provider business mailing address
2820 ARMSTRONG AVE
CLERMONT FL
34714-8100
US
V. Phone/Fax
- Phone: 385-232-1869
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMUEL
MCDONNELL
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LMHC
Phone: 385-232-1869