Healthcare Provider Details

I. General information

NPI: 1922528306
Provider Name (Legal Business Name): VASSILIA BINENSZTOK LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13700 US HIGHWAY 1 STE 202A
JUNO BEACH FL
33408-1600
US

IV. Provider business mailing address

13700 US HIGHWAY 1 STE 202A
JUNO BEACH FL
33408-1600
US

V. Phone/Fax

Practice location:
  • Phone: 561-316-7738
  • Fax:
Mailing address:
  • Phone: 561-316-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: