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Organization
VIDA BEHAVIORAL HEALTH ASSOCIATES, LLC
Active
Organization
VIDA BEHAVIORAL HEALTH ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSSI PEREZ LMHC (LICENSED MENTAL HEALTH COUNSELOR)
(401) 862-7292
Entity
Organization
Contact information
Practice address
3307 NORTHLAKE BLVD STE B104, PALM BEACH GARDENS, FL 33403-1703
(561) 618-5072
Mailing address
3307 NORTHLAKE BLVD STE B104, PALM BEACH GARDENS, FL 33403-1703
(401) 862-7292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13781
FL
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ATN693995
—
FL
Enumeration date
02/09/2018
Last updated
11/18/2022
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