Healthcare Provider Details

I. General information

NPI: 1730533035
Provider Name (Legal Business Name): PSYCHOLOGICAL & BEHAVIORAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CARIBBEAN BLVD STE 101
CUTLER BAY FL
33189-1224
US

IV. Provider business mailing address

9800 HAITIAN DR
CUTLER BAY FL
33189-1612
US

V. Phone/Fax

Practice location:
  • Phone: 786-302-5303
  • Fax:
Mailing address:
  • Phone: 786-348-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ANA ESCALONA
Title or Position: CEO
Credential:
Phone: 786-348-4813