Healthcare Provider Details

I. General information

NPI: 1316400377
Provider Name (Legal Business Name): MINDY R APPEL LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W ATLANTIC AVE STE 408
DELRAY BEACH FL
33484-8141
US

IV. Provider business mailing address

5300 W ATLANTIC AVE STE 408
DELRAY BEACH FL
33484-8141
US

V. Phone/Fax

Practice location:
  • Phone: 561-926-7858
  • Fax:
Mailing address:
  • Phone: 561-926-7858
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PATTY GEORGE
Title or Position: OFFICE MANAGE
Credential:
Phone: 324-430-1090