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General NPI Number Information
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NPI Number | 1841092137
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Entity Type | Organization
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Legal Business Name | HEADSTRONG BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1049 JOHN SIMS PKWY PALM PLAZA
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City | NICEVILLE
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State | FL
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Zip | 32578
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Country | US
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Telephone | 850-706-0011
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Fax | 850-378-5237
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Provider Business Mailing Address
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Address Line | 1723 PINE AVE
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City | NICEVILLE
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State | FL
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Zip | 32578-4600
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Country | US
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Telephone | 850-368-4670
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRIAN W PULLAM
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Credential | APRN, FNP, PHMNP-BC
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Telephone | 850-368-4670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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