Provider Demographics
NPI:1174916563
Name:CAMEN BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:CAMEN BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:LOTTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:407-687-4439
Mailing Address - Street 1:5959 LAKE ELLENOR DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4633
Mailing Address - Country:US
Mailing Address - Phone:321-972-4039
Mailing Address - Fax:321-445-9760
Practice Address - Street 1:5959 LAKE ELLENOR DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4633
Practice Address - Country:US
Practice Address - Phone:407-490-1453
Practice Address - Fax:321-445-9760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 103K00000X
FL014487800252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017804800Medicaid
FL014487800Medicaid
FL100957300Medicaid