Organization Active NPI

Neurocove Behavioral Health, LLC

  • Clinical Psychologist
  • Orlando, FL
National Provider Identifier
1356925861
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
NEUROCOVE BEHAVIORAL HEALTH, LLC
Practice address
1317 Edgewater Dr # 117
Orlando, FL 32804-6350
Phone
(321) 754-9099
NPI assigned
May 11, 2021
Last updated
Oct 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Benson George Munyan III, PHDNPI 1205328390
Title
Director
Phone
(321) 754-9099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

1317 Edgewater Dr # 117
Orlando, FL 32804-6350

Mailing address

3564 Avalon Park E Blvd Ste 1
Ipmb 3039
Orlando, FL 32828-6350
Phone (321) 754-9099

Other identifiers 1

IdentifierTypeStateIssuer
1AOUIOtherFLBCBS FLORIDA BLUE

Other names 1

  • Benson Munyan, PhD Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@neurocovebehavioralhealth.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220917000635 FL Part B Supplier - Clinic/Group Practice 8022493600 Receives reassigned benefits from 2 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

3564 E Avalon Park Blvd
Ste 1
Orlando, FL 32828
Phone (305) 842-4947

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1356925861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 AVALON PARK E BLVD STE 1",
            "address_2": "IPMB 3039",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286350",
            "telephone_number": "321-754-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR # 117",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "telephone_number": "321-754-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCOVE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "MUNYAN",
        "authorized_official_first_name": "BENSON",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "321-754-9099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA BLUE",
            "identifier": "1AOUI",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@neurocovebehavioralhealth.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "None",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Contact INfo",
            "address_1": "1317 Edgewater Dr # 117",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328046350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Benson Munyan, PhD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.