LIVE OAK BEHAVIORAL HEALTH PA (NPI# 1508368192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508368192 |
| Entity Type | Organization |
| Organization Name | LIVE OAK BEHAVIORAL HEALTH PA |
| Other Organization Name | LIVE OAK BEHAVIORAL HEALTH |
| Practice Address |
341 N Maitland Ave Ste 120 Maitland FL 32751-4761 |
| Practice Telephone | 4077562084 |
| Practice Fax Number | 8664952994 |
| Mailing Telephone | 4077562084 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | DR. DANIEL PAULSON (CO-OWNER) |
| Authorized Official Telephone | 4077562084 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PY9901 | FL | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Live Oak Behavioral Health | Doing Business As Name - Organization |
| Street Address |
341 N MAITLAND AVE STE 120 |
| City | MAITLAND |
| State | FL |
| Zip Code | 32751-4761 |
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| 1821616228 | Katherine Tchir | Anesthesiologist Assistant | 851 Trafalgar Court Suite 200e, Maitland, FL 32751 | 2020-07-12 |
| 1699309518 | Karin Scotchie | Occupational Therapist | 1700 Monroe Rd, Maitland, FL 32751 | 2020-02-29 |
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| 1427528074 | Auricular Health Center | Clinic/Center | 237 Lookout Place, Maitland, FL 32751 | 2018-11-27 |
| 1710456181 | Yadiel Munoz | Counselor | 5786, 225 S Swoope Ave # 211, Maitland, FL 32751 | 2018-11-15 |
| 1780152678 | Rebecca Hernandez | Case Manager/Care Coordinator | 1000 Winderley Pl Unit 221, Maitland, FL 32751 | 2018-11-08 |
| 1548742901 | David Cromer | Social Worker | 225 S. Swoope Ave #211, Maitland, FL 32751 | 2018-09-02 |
| Find all providers in zip 32751 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.