MEDICARE: ROAR COUNSELOR & BEHAVIOR THERAPY 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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548996630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROAR COUNSELOR & BEHAVIOR THERAPY LLC

Provider Business Mailing Address
First Line	:	3157 N UNIVERSITY DR STE 108
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2258
Country	:	US
Telephone Number	:	786-715-7622
Fax Number	:	561-972-5845

Provider Business Practice Location Address
First Line	:	3157 N UNIVERSITY DR STE 108
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2258
Country	:	US
Telephone Number	:	561-764-7093
Fax Number	:	561-972-5845

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBEL CORREA
Credential	:
Telephone Number	:	561-764-7093

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	02/11/2026

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