Healthcare Provider Details

I. General information

NPI: 1588681910
Provider Name (Legal Business Name): JENNIFER FRUMER-NEWSTEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 06/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 CORPORATE WAY SUITE 200
WEST PALM BEACH FL
33407-2039
US

IV. Provider business mailing address

PO BOX 220627
WEST PALM BEACH FL
33422-0627
US

V. Phone/Fax

Practice location:
  • Phone: 561-684-1991
  • Fax: 561-828-9272
Mailing address:
  • Phone: 561-684-1991
  • Fax: 561-828-9272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH1735
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW2595
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: