=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023439262
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SILVI JANTUNEN PSYD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2013
-----------------------------------------------------
Last Update Date | 12/13/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2393 S CONGRESS AVE STE 226
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33406-7628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-523-0661
-----------------------------------------------------
Fax | 561-649-0210
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2393 S CONGRESS AVE STE 226
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33406-7628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-523-0661
-----------------------------------------------------
Fax | 561-649-0210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF PSYCHOLOGY
-----------------------------------------------------
Name | DR. SILVI P JANTUNEN
-----------------------------------------------------
Credential | PSY.D.
-----------------------------------------------------
Telephone | 561-523-0661
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number | PY7853
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------