Provider Type Icon

PEDIATRIC BEHAVIORAL HEALTH ASSOCIATES INC. NPI 1861953523


NPI Information

NPI: 1861953523
Provider Name: PEDIATRIC BEHAVIORAL HEALTH ASSOCIATES, INC.

Doing Business As: PEDIATRIC BEHAVIORAL HEALTH ASSOCIATES OF MARION COUNTY

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
5818 SE AGNEW RD
BELLEVIEW, FL
ZIP 34420
Phone: (561) 706-1004
Get Directions

PEDIATRIC BEHAVIORAL HEALTH ASSOCIATES, INC. is a clinical social worker in Belleview, FL. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. PEDIATRIC BEHAVIORAL HEALTH ASSOCIATES, INC. NPI is 1861953523. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Pediatric Behavioral Health Associates Of Marion County.

The provider's business location address is:

5818 SE AGNEW RD
BELLEVIEW, FL
ZIP 34420-020
Phone: (561) 706-1004
Fax: (561) 892-0268

The provider's authorized official is Nikki Woller .
The authorized official title is President and has the following contact phone number (561) 706-1004.

The enumeration date for this NPI number is 3/26/2019 and was last updated on 3/20/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologistNo
2103TB0200XPsychologistCognitive & BehavioralNo
3103TC2200XPsychologistClinical Child & AdolescentNo
41041C0700XSocial WorkerClinicalYes
5171M00000XCase Manager/Care CoordinatorNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1767023100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.