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General NPI Number Information
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NPI Number | 1699599084
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Entity Type | Organization
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Legal Business Name | CBT & ABA BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 4432 BLUE BILL PASS
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6936
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Country | US
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Telephone | 850-933-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 4432 BLUE BILL PASS
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6936
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Country | US
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Telephone | 850-933-0218
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Fax |
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Authorized Official
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Title or Position | OWNER, LMHC
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Name | ELENA REYES-RUNYON
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Credential | LMHC, BCBA
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Telephone | 850-933-0218
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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 |
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License Number State |
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