Healthcare Provider Details

I. General information

NPI: 1356034219
Provider Name (Legal Business Name): PSYCHTALK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2023
Last Update Date: 05/29/2023
Certification Date: 05/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 LAHANA CIR
BOYNTON BEACH FL
33437-7174
US

IV. Provider business mailing address

7310 LAHANA CIR
BOYNTON BEACH FL
33437-7174
US

V. Phone/Fax

Practice location:
  • Phone: 240-535-9294
  • Fax:
Mailing address:
  • Phone: 240-535-9294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERRIL SCHWARTZ
Title or Position: OWNER
Credential: LCSW
Phone: 240-535-9294