Healthcare Provider Details

I. General information

NPI: 1134308034
Provider Name (Legal Business Name): STANTON ROY ERLICHMAN PHD LMFT CAP CEDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: S ROY ERLICHMAN

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 NORTHLAKE BLVD ERE ASSOCIATES SUITE 212
PALM BEACH GARDENS FL
33403-1712
US

IV. Provider business mailing address

7325 SW 63RD AVENUE ERE ASSOCIATES SUITE 101
SOUTH MIAMI FL
33143-4812
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-8070
  • Fax: 561-626-2828
Mailing address:
  • Phone: 305-284-1143
  • Fax: 305-667-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC762
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT1462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: