Healthcare Provider Details
I. General information
NPI: 1548558315
Provider Name (Legal Business Name): LAURA A. ZIPRIS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2011
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5300 W ATLANTIC AVE SUITE 604
DELRAY BEACH FL
33484-8165
US
IV. Provider business mailing address
5300 W ATLANTIC AVE SUITE 604
DELRAY BEACH FL
33484-8165
US
V. Phone/Fax
- Phone: 561-558-7815
- Fax: 561-637-4446
- Phone: 561-558-7815
- Fax: 561-637-4446
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH9456 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 0161311 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | SS866 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
LAURA
AILEEN
ZIPRIS
Title or Position: PRESIDENT
Credential: PSY.D., LMHC, LSP
Phone: 561-558-7815