Healthcare Provider Details

I. General information

NPI: 1275296097
Provider Name (Legal Business Name): CAMEN BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 INDUSTRIAL DR # 206
DELAND FL
32724-2039
US

IV. Provider business mailing address

5959 LAKE ELLENOR DR
ORLANDO FL
32809-4633
US

V. Phone/Fax

Practice location:
  • Phone: 321-972-4039
  • Fax: 321-445-9760
Mailing address:
  • Phone: 321-972-4039
  • Fax: 321-445-9760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE ALEXIS RICH LOTTMAN
Title or Position: CEO
Credential:
Phone: 321-972-4039