| Neurocove Behavioral Health, Llc | |
|
1317 Edgewater Dr # 117 Orlando FL 32804-6350 | |
| (321) 754-9099 | |
| Not Available |
| Full Name | Neurocove Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1317 Edgewater Dr # 117, Orlando, Florida |
| Authorized Official Name and Position | Benson George Munyan (DIRECTOR) |
| Authorized Official Contact | 3217549099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurocove Behavioral Health, Llc 3564 Avalon Park E Blvd Ste 1 Ipmb 3039 Orlando FL 32828-6350 Ph: (321) 754-9099 | Neurocove Behavioral Health, Llc 1317 Edgewater Dr # 117 Orlando FL 32804-6350 Ph: (321) 754-9099 |
| NPI Number | 1356925861 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Medicare PECOS PAC ID | 8022493600 |
|---|---|
| Medicare Enrollment ID | O20220917000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356925861 | NPI | - | NPPES |
| 1AOUI | Other | FL | BCBS FLORIDA BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Benson George Munyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205328390 PECOS PAC ID: 9931584513 Enrollment ID: I20220917000636 |
| Provider Name | Nicholas Taylor James |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104498252 PECOS PAC ID: 2264890698 Enrollment ID: I20230616001847 |
| Provider Name | Jessica Candelo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932863701 PECOS PAC ID: 6204286313 Enrollment ID: I20240102000595 |
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