Provider Demographics
NPI:1861767824
Name:PSYCHOTHERAPY OF THE PALM BEACHES, PLLC
Entity type:Organization
Organization Name:PSYCHOTHERAPY OF THE PALM BEACHES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-385-8900
Mailing Address - Street 1:232 SEDONA WAY
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1714
Mailing Address - Country:US
Mailing Address - Phone:561-385-8900
Mailing Address - Fax:
Practice Address - Street 1:232 SEDONA WAY
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-1714
Practice Address - Country:US
Practice Address - Phone:561-385-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW106151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty