Healthcare Provider Details

I. General information

NPI: 1568853323
Provider Name (Legal Business Name): INSIGHT BEHAVIORAL HEALTH SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 N MAIN ST 1320 N MAIN ST
KISSIMMEE FL
34744-5262
US

IV. Provider business mailing address

618 N MAIN ST SUITE B
KISSIMMEE FL
34744-5262
US

V. Phone/Fax

Practice location:
  • Phone: 407-343-6006
  • Fax: 407-343-8289
Mailing address:
  • Phone: 407-343-6006
  • Fax: 407-343-8289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLGA A BARRETO
Title or Position: C.E.O
Credential: M.ED.
Phone: 407-922-9241