Provider Demographics
NPI:1558102558
Name:CARSWELL, ALENA
Entity type:Individual
Prefix:
First Name:ALENA
Middle Name:
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 DANIELS RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4376
Mailing Address - Country:US
Mailing Address - Phone:407-395-9976
Mailing Address - Fax:407-992-9368
Practice Address - Street 1:1450 DANIELS RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4376
Practice Address - Country:US
Practice Address - Phone:407-395-9976
Practice Address - Fax:407-992-9368
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-308770106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician