Provider Demographics
NPI:1326682410
Name:BEHAVIOR INTEGRATIONS, LLC
Entity Type:Organization
Organization Name:BEHAVIOR INTEGRATIONS, LLC
Other - Org Name:BEHAVIOR INTEGRATIONS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRACERO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:407-937-9016
Mailing Address - Street 1:3641 HADDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5690
Mailing Address - Country:US
Mailing Address - Phone:407-937-9016
Mailing Address - Fax:407-703-9561
Practice Address - Street 1:498 N STATE ROAD 434 STE 1011
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2172
Practice Address - Country:US
Practice Address - Phone:407-810-5315
Practice Address - Fax:407-703-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1730417239Medicaid
FL018800600Medicaid