Healthcare Provider Details

I. General information

NPI: 1265822597
Provider Name (Legal Business Name): JMS PSYCHOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NW 17TH AVE SUITE 13
DELRAY BEACH FL
33445-2503
US

IV. Provider business mailing address

1200 NW 17TH AVE SUITE 13
DELRAY BEACH FL
33445-2503
US

V. Phone/Fax

Practice location:
  • Phone: 917-923-1336
  • Fax:
Mailing address:
  • Phone: 917-923-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8093
License Number StateFL

VIII. Authorized Official

Name: DR. JILL SCHWARTZBERG
Title or Position: PSYCHOLOGIST
Credential: PSY.D
Phone: 917-923-1336