=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003775115
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | K S BEHAVIOR AND MENTAL HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2026
-----------------------------------------------------
Last Update Date | 01/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 123 N KROME AVE STE 204
-----------------------------------------------------
City | HOMESTEAD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33030-6002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-572-5093
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 123 N KROME AVE STE 204
-----------------------------------------------------
City | HOMESTEAD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33030-6002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-572-5093
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PYSCHOTHERAPIST/OWNER
-----------------------------------------------------
Name | MRS. KYRIE S SALTERS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 786-572-5093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------