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General NPI Number Information
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NPI Number | 1174760912
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Entity Type | Organization
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Legal Business Name | THE ODYSSEY FOUNDATION INC
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 205 NE 5TH TER
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3866
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Country | US
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Telephone | 561-276-0020
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Fax | 561-265-0333
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Provider Business Mailing Address
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Address Line | 205 NE 5TH TER
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3866
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Country | US
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Telephone | 561-276-0020
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Fax | 561-265-0333
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOTHERAPIST
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Name | MRS. ELIZABETH ANNE CAPARROS
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Credential | MSW, LCSW
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Telephone | 561-573-3595
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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 | SW00003210
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License Number State | FL
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