Provider Demographics
NPI:1700671385
Name:LADYBUG BEHAVIORAL SOLUTIONS LLC
Entity type:Organization
Organization Name:LADYBUG BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKEVIA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:954-483-1005
Mailing Address - Street 1:3811 SAN ISIDRO CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-8377
Mailing Address - Country:US
Mailing Address - Phone:954-483-1005
Mailing Address - Fax:954-483-1005
Practice Address - Street 1:205 S DIXIE DR STE 180
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-2873
Practice Address - Country:US
Practice Address - Phone:863-312-2347
Practice Address - Fax:863-312-3247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty