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NPI Code Detail

MEDICARE: WALTER MARIANO THAMSTEN LMHC

MEDICARE: WALTER MARIANO THAMSTEN LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH10039FL

General Provider Information

NPI Number : 1093296360
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER MARIANO THAMSTEN LMHC
Provider Business Mailing Address
First Line : 1605 RENAISSANCE COMMONS BLVD APT 230
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-8283
Country : US
Telephone Number : 954-232-4695
Fax Number :
Provider Business Practice Location Address
First Line : 200 CONGRESS PARK DR STE 100
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-4618
Country : US
Telephone Number : 954-232-4695
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2018
Last Update Date : 01/16/2020

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