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General NPI Number Information
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NPI Number | 1063788099
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Entity Type | Organization
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Legal Business Name | PALM BEACH COUNSELING, LLC
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 9325 GLADES RD SUITE 208
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City | BOCA RATON
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State | FL
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Zip | 33434-3988
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Country | US
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Telephone | 561-214-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 9325 GLADES RD SUITE 208
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City | BOCA RATON
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State | FL
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Zip | 33434-3988
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Country | US
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Telephone | 561-214-0705
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMANDA BARTELL
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Credential | M.ED, LMHC
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Telephone | 561-214-0705
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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 | 10428
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License Number State | FL
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