Provider Demographics
NPI:1982195228
Name:SQUARE ONE BEHAVIORAL SERVICES INC.
Entity Type:Organization
Organization Name:SQUARE ONE BEHAVIORAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LEIDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-667-2181
Mailing Address - Street 1:1495 FOREST HILL BLVD STE C3
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6073
Mailing Address - Country:US
Mailing Address - Phone:561-667-2181
Mailing Address - Fax:
Practice Address - Street 1:1495 FOREST HILL BLVD STE C3
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6073
Practice Address - Country:US
Practice Address - Phone:561-667-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-17-26196103K00000X
103K00000X, 103TC0700X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty