| Behavioral Health Minute Clinic Llc | |
|
1971 Lee Rd Ste 203 Winter Park FL 32789-1875 | |
| (407) 450-8151 | |
| (321) 363-1912 |
| Full Name | Behavioral Health Minute Clinic Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1971 Lee Rd Ste 203, Winter Park, Florida |
| Authorized Official Name and Position | Rena Peterson (OWNER) |
| Authorized Official Contact | 5617029216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Minute Clinic Llc 466 Woldunn Cir Lake Mary FL 32746-5914 Ph: (561) 702-9216 | Behavioral Health Minute Clinic Llc 1971 Lee Rd Ste 203 Winter Park FL 32789-1875 Ph: (407) 450-8151 |
| NPI Number | 1336704154 |
|---|---|
| Provider Enumeration Date | 05/07/2019 |
| Last Update Date | 05/09/2019 |
| Medicare PECOS PAC ID | 2860726114 |
|---|---|
| Medicare Enrollment ID | O20190620002097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336704154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| Provider Name | Rena Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306012919 PECOS PAC ID: 7416013321 Enrollment ID: I20090302000251 |
| Provider Name | Dally Ivette Rios-ortega |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659621324 PECOS PAC ID: 6406007517 Enrollment ID: I20121120000394 |
| Provider Name | Antonio Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669033577 PECOS PAC ID: 4486983343 Enrollment ID: I20190903001494 |
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