MEDICARE: SPECTRUM PROGRAMS INC

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	101YM0800X	Mental Health Counselor
2	101Y00000X	Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	106H00000X	Marriage & Family Therapist
5	2084P0804X	Child & Adolescent Psychiatry Physician
6	2084P0800X	Psychiatry Physician
7	1041C0700X	Clinical Social Worker
8	104100000X	Social Worker
9	164W00000X	Licensed Practical Nurse
10	103T00000X	Psychologist
11	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	1706AD598101	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902852304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM PROGRAMS INC

Provider Business Mailing Address
First Line	:	11031 NE 6TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33161-7182
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:	305-757-4465

Provider Business Practice Location Address
First Line	:	790 E BROWARD BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2095
Country	:	US
Telephone Number	:	954-781-4405
Fax Number	:	954-785-6120

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	BRUCE HAYDEN
Credential	:	LMHC
Telephone Number	:	305-398-6100

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/12/2013

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Directions to “SPECTRUM PROGRAMS INC ” Practice Location

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