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General NPI Number Information
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NPI Number | 1558606210
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Entity Type | Organization
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Legal Business Name | BIRD BEHAVIORAL SERVICES INC.
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 816 PENNSYLVANIA AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-3371
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Country | US
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Telephone | 321-805-4426
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Fax | 407-902-0019
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Provider Business Mailing Address
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Address Line | 816 PENNSYLVANIA AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-3371
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Country | US
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Telephone | 321-805-4426
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Fax | 407-902-0019
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MS. ALMA T. BIRD
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Credential | BCBA
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Telephone | 321-805-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 5536
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-05-2139
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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