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General NPI Number Information
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NPI Number | 1063396455
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Entity Type | Organization
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Legal Business Name | IRECOVERY, LLC
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 575 S WICKHAM RD STE F-522
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City | MELBOURNE
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State | FL
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Zip | 32904-1100
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Country | US
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Telephone | 321-215-4477
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Fax | 561-464-5501
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Provider Business Mailing Address
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Address Line | 5030 CHAMPION BLVD # G11-535
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City | BOCA RATON
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State | FL
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Zip | 33496-2473
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Country | US
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Telephone | 561-235-7685
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Fax | 561-235-7685
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VERONICA CASTELLANO
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Credential |
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Telephone | 561-464-5500
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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