Healthcare Provider Details

I. General information

NPI: 1922545490
Provider Name (Legal Business Name): PREVENTIVE BEHAVIORS & SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W OLD US HIGHWAY 441 STE 105
MOUNT DORA FL
32757-3536
US

IV. Provider business mailing address

2799 W OLD US HIGHWAY 441 STE 105
MOUNT DORA FL
32757-3536
US

V. Phone/Fax

Practice location:
  • Phone: 352-874-9802
  • Fax: 352-388-5479
Mailing address:
  • Phone: 352-874-9802
  • Fax: 352-388-5479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VICTORIA DENISE WEEKS EVANS
Title or Position: OWNER
Credential: BCBA, M.A.
Phone: 352-874-9802