Provider Demographics
NPI:1700983426
Name:JENNINGS' APPLIED BEHAVIOR & COGNITIVE CENTER, INC.
Entity Type:Organization
Organization Name:JENNINGS' APPLIED BEHAVIOR & COGNITIVE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LMHC, BCBA
Authorized Official - Phone:321-779-0213
Mailing Address - Street 1:1275 S PATRICK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3963
Mailing Address - Country:US
Mailing Address - Phone:321-779-0213
Mailing Address - Fax:321-773-0497
Practice Address - Street 1:1275 S PATRICK DR
Practice Address - Street 2:SUITE C
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3963
Practice Address - Country:US
Practice Address - Phone:321-779-0213
Practice Address - Fax:321-773-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty