Advanced Behavioral Clinicians, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

ADVANCED BEHAVIORAL CLINICIANS, LLC

Doing business as

Advancd behavioral Clinicians

Practice address

2650 Bahia Vista St Ste 209
Sarasota, FL 34239-2625

Phone

(941) 870-3600

Fax

(727) 998-8401

NPI assigned

May 29, 2020

Last updated

Aug 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adair Lynne Deicke, PMHNP-BCNPI 1922185628

Title

Owner/Ceo

Phone

(727) 239-9938

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Advancd behavioral Clinicians Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Adair Lynne Deicke

  • Psychiatric/Mental Health Nurse Practitioner
  • Sarasota, FL
  • NPI 1922185628
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1639793326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEADOWBROOK LN",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691134",
            "telephone_number": "941-870-3600",
            "fax_number": "727-998-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST STE 209",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392625",
            "telephone_number": "941-870-3600",
            "fax_number": "727-998-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 Coconut Bay Ln Unit 3G",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342373055",
            "country_code": "US",
            "telephone_number": "941-870-3600",
            "fax_number": "727-998-8401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Hyde Park St",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393612",
            "country_code": "US",
            "telephone_number": "727-239-9938",
            "fax_number": "727-998-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED BEHAVIORAL CLINICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "DEICKE",
        "authorized_official_first_name": "ADAIR",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "727-239-9938",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008642300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advancd behavioral Clinicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Nurse Practitioner in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.