Provider Demographics
NPI:1710031190
Name:CENTER OF PSYCHOLOGICAL EFFECTIVENESS, INC.
Entity type:Organization
Organization Name:CENTER OF PSYCHOLOGICAL EFFECTIVENESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:MAROTTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-583-8831
Mailing Address - Street 1:6950 CYPRESS RD
Mailing Address - Street 2:UNIT 103A
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2382
Mailing Address - Country:US
Mailing Address - Phone:954-583-8831
Mailing Address - Fax:954-583-9575
Practice Address - Street 1:6950 CYPRESS RD
Practice Address - Street 2:UNIT 103A
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2382
Practice Address - Country:US
Practice Address - Phone:954-583-8831
Practice Address - Fax:954-583-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 0003973103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33687Medicare PIN