MEDICARE: SERIOUSLY INTELLIGENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134073513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERIOUSLY INTELLIGENT LLC

Provider Business Mailing Address
First Line	:	1940 POINTE DR
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-0285
Country	:	US
Telephone Number	:	404-751-6245
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 POINTE DR
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-0285
Country	:	US
Telephone Number	:	404-751-6245
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA HALLMAN
Credential	:
Telephone Number	:	404-751-6245

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	05/11/2026

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