Healthcare Provider Details

I. General information

NPI: 1396664108
Provider Name (Legal Business Name): BRYAN T. ASTON LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5072 NW 66TH DR
CORAL SPRINGS FL
33067-2109
US

IV. Provider business mailing address

PO BOX 880207
BOCA RATON FL
33488-0207
US

V. Phone/Fax

Practice location:
  • Phone: 917-485-9664
  • Fax:
Mailing address:
  • Phone: 561-482-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRYAN T ASTON JR.
Title or Position: LCSW
Credential: LCSW
Phone: 917-485-9664