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General NPI Number Information
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NPI Number | 1063435279
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Entity Type | Individual
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Provider Name | RICHARD J. LOEBL LCSW, BCD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7284 W PALMETTO PARK RD SUITE 201
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City | BOCA RATON
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State | FL
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Zip | 33433-3406
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Country | US
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Telephone | 561-955-6090
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Fax |
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Provider Business Mailing Address
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Address Line | 381 NW 36TH AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8013
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Country | US
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Telephone | 561-955-6090
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW6025
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License Number State | FL
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