Organization
ADVANCED BEHAVIORAL CLINICIANS, LLC
Active
Other names
Advancd behavioral Clinicians
Organization subpart
No
Provider details
NPI number
Authorized official
ADAIR LYNNE DEICKE PMHNP-BC (OWNER/CEO)
(727) 239-9938
Entity
Organization
Contact information
Practice address
2650 BAHIA VISTA ST STE 209, SARASOTA, FL 34239-2625
(941) 870-3600
(727) 998-8401
Mailing address
20 MEADOWBROOK LN, PALMER, MA 01069-1134
(941) 870-3600
(727) 998-8401
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008642300
—
FL
Enumeration date
05/29/2020
Last updated
08/26/2022
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