Healthcare Provider Details

I. General information

NPI: 1982958146
Provider Name (Legal Business Name): LOUIS A HANEEF LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BLUE HERON BLVD W
RIVIERA BEACH FL
33404-5003
US

IV. Provider business mailing address

43 COPPERPOD CT
ROYAL PALM BEACH FL
33411-1653
US

V. Phone/Fax

Practice location:
  • Phone: 561-460-7840
  • Fax:
Mailing address:
  • Phone: 561-460-7840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH11258
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: