Healthcare Provider Details

I. General information

NPI: 1508267980
Provider Name (Legal Business Name): BEHAVIORAL PROGRESSION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 FITZGERALD RD STE 1
LAKELAND FL
33813-2620
US

IV. Provider business mailing address

304 E PINE ST # 1252
LAKELAND FL
33801-4969
US

V. Phone/Fax

Practice location:
  • Phone: 813-602-0068
  • Fax: 813-354-2715
Mailing address:
  • Phone: 863-602-0698
  • Fax: 813-354-2715

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 Number1-14-15928
License Number StateFL

VIII. Authorized Official

Name: MRS. NICOLE MINARD
Title or Position: OWNER
Credential: M.A., BCBA
Phone: 863-602-0698