Healthcare Provider Details

I. General information

NPI: 1588967236
Provider Name (Legal Business Name): TRUMPET BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746-5028
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY
LAKE MARY FL
32746-5035
US

V. Phone/Fax

Practice location:
  • Phone: 303-989-8169
  • Fax: 303-984-4366
Mailing address:
  • Phone: 303-989-8169
  • Fax: 303-984-4366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICKI KEATING
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 303-989-8169