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General NPI Number Information
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NPI Number | 1053566679
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Entity Type | Individual
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Provider Name | MICHELLE BETH SUKENIK PSY.D., LMHC, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 9960 CENTRAL PARK BLVD N SUITE 235
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City | BOCA RATON
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State | FL
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Zip | 33428-1759
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Country | US
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Telephone | 561-483-0844
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Fax |
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Provider Business Mailing Address
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Address Line | 9960 CENTRAL PARK BLVD N SUITE 235
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City | BOCA RATON
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State | FL
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Zip | 33428-1759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NCC #263011
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC #MH8300
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License Number State | FL
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