Provider Demographics
NPI:1659042117
Name:PROFICIENT INTEGRATION MENTAL HEALTH LLC.
Entity Type:Organization
Organization Name:PROFICIENT INTEGRATION MENTAL HEALTH LLC.
Other - Org Name:PROFICIENT INTEGRATION MENTAL HEALTH LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TURNER- SNAGG
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:469-216-4017
Mailing Address - Street 1:14819 CRESCENT ROCK DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-6196
Mailing Address - Country:US
Mailing Address - Phone:469-216-4017
Mailing Address - Fax:
Practice Address - Street 1:911 S PARSONS AVE STE D
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6042
Practice Address - Country:US
Practice Address - Phone:813-922-8240
Practice Address - Fax:855-941-2554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty