| Cognitive Behavior Champions Llc | |
|
855 Outer Rd Orlando FL 32814-6652 | |
| (407) 247-2933 | |
| Not Available |
| Full Name | Cognitive Behavior Champions Llc |
|---|---|
| Speciality | Social Worker |
| Location | 855 Outer Rd, Orlando, Florida |
| Authorized Official Name and Position | Solomon Richberg (CEO) |
| Authorized Official Contact | 4072472933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Behavior Champions Llc 855 Outer Rd Orlando FL 32814-6652 Ph: (407) 247-2933 | Cognitive Behavior Champions Llc 855 Outer Rd Orlando FL 32814-6652 Ph: (407) 247-2933 |
| NPI Number | 1891565156 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/06/2024 |
| Medicare PECOS PAC ID | 2769826213 |
|---|---|
| Medicare Enrollment ID | O20240222004255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891565156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Solomon Rashawn Richberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245704337 PECOS PAC ID: 3678917127 Enrollment ID: I20240222004283 |
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