Healthcare Provider Details

I. General information

NPI: 1730664442
Provider Name (Legal Business Name): AC BEHAVIORAL CONSULTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9999 NE 2ND AVE STE 204
MIAMI SHORES FL
33138-2345
US

IV. Provider business mailing address

9999 NE 2ND AVE STE 204
MIAMI SHORES FL
33138-2345
US

V. Phone/Fax

Practice location:
  • Phone: 305-798-6784
  • Fax:
Mailing address:
  • Phone: 305-798-6784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ARIADNA CUSON
Title or Position: PRESIDENT
Credential: BCBA
Phone: 305-519-2855