Provider Demographics
NPI:1730556507
Name:LAURIE A. SPATARO
Entity type:Organization
Organization Name:LAURIE A. SPATARO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPATARO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAP
Authorized Official - Phone:561-713-8511
Mailing Address - Street 1:9589 VERONA LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2759
Mailing Address - Country:US
Mailing Address - Phone:561-713-8511
Mailing Address - Fax:
Practice Address - Street 1:1490 S MILITARY TRL
Practice Address - Street 2:SUITE 7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-9190
Practice Address - Country:US
Practice Address - Phone:561-713-8511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADC0075712015101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty