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General NPI Number Information
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NPI Number | 1083968721
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCHOTHERAPY NETWORK,INCORPORATED
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 1825 FOREST HILL BLVD SUITE 103
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-8902
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Country | US
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Telephone | 561-967-3266
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Fax | 561-968-1565
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Provider Business Mailing Address
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Address Line | 1825 FOREST HILL BLVD SUITE 103
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-8902
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Country | US
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Telephone | 561-967-3266
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Fax | 561-968-1565
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NANCY KAREN PERSENAIRE
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Credential | L.C.S.W.
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Telephone | 561-967-3266
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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 | SW000866
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License Number State | FL
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