Healthcare Provider Details

I. General information

NPI: 1316315260
Provider Name (Legal Business Name): PSYCHNOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 S CONGRESS AVE SUITE 103
DELRAY BEACH FL
33445-6300
US

IV. Provider business mailing address

1615 S CONGRESS AVE SUITE 103
DELRAY BEACH FL
33445-6300
US

V. Phone/Fax

Practice location:
  • Phone: 561-287-1808
  • Fax: 928-708-9620
Mailing address:
  • Phone: 561-287-1808
  • Fax: 928-708-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LISSI SENEWAY
Title or Position: REPRESENTATIVE
Credential:
Phone: 561-287-1808