Healthcare Provider Details
I. General information
NPI: 1588590053
Provider Name (Legal Business Name): SEAGLASS WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 NORTH RD
BOYNTON BEACH FL
33435-3237
US
IV. Provider business mailing address
630 NORTH RD
BOYNTON BEACH FL
33435-3237
US
V. Phone/Fax
- Phone: 561-385-3520
- Fax:
- Phone: 561-385-3520
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HEATHER
CRESSWELL
Title or Position: AUTHORIZED MEMBER
Credential: ED.D., LMHC,LPC,ACS
Phone: 561-385-3520