| Southeastern Behavioral Health, Llc | |
|
3303 Thomasville Rd Ste 102 Tallahassee FL 32308-7912 | |
| (850) 296-3665 | |
| (850) 296-3665 |
| Full Name | Southeastern Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3303 Thomasville Rd Ste 102, Tallahassee, Florida |
| Authorized Official Name and Position | Angela Canto (OWNER/AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 8502963665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Behavioral Health, Llc 3303 Thomasville Rd Ste 102 Tallahassee FL 32308-7912 Ph: (850) 296-3665 | Southeastern Behavioral Health, Llc 3303 Thomasville Rd Ste 102 Tallahassee FL 32308-7912 Ph: (850) 296-3665 |
| NPI Number | 1689164790 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 12/28/2019 |
| Certification Date | 12/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689164790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY10048 (Florida) | Primary |
| 103TS0200X | Psychologist - School | SS1033 (Florida) | Secondary |
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