Healthcare Provider Details

I. General information

NPI: 1760460653
Provider Name (Legal Business Name): CHARLOTTE BEHAVIORAL HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 EDUCATION AVE
PUNTA GORDA FL
33950-6222
US

IV. Provider business mailing address

1700 EDUCATION AVE
PUNTA GORDA FL
33950-6222
US

V. Phone/Fax

Practice location:
  • Phone: 941-639-8300
  • Fax: 941-347-6493
Mailing address:
  • Phone: 941-639-8300
  • Fax: 941-347-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0808AD492200
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0808AD492200
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0808AD492200
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1477
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number2008AD4922-00-P
License Number StateFL

VIII. Authorized Official

Name: MRS. VICTORIA SCANLON
Title or Position: CEO
Credential: LMHC
Phone: 941-639-8300