Healthcare Provider Details

I. General information

NPI: 1982195228
Provider Name (Legal Business Name): SQUARE ONE BEHAVIORAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S STATE ROAD 7 STE 174
ROYAL PALM BEACH FL
33414-4306
US

IV. Provider business mailing address

420 S STATE ROAD 7 STE 174
ROYAL PALM BEACH FL
33414-4306
US

V. Phone/Fax

Practice location:
  • Phone: 561-667-2181
  • Fax: 561-247-7860
Mailing address:
  • Phone: 561-667-2181
  • Fax: 561-247-7860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-26196
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LEIDA C ALARCON
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: BCBA
Phone: 561-667-2181