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General NPI Number Information
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NPI Number | 1245714625
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Entity Type | Individual
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Provider Name | ANNEMARIE PHELAN MS, LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 1555 PALM BEACH LAKES BLVD STE 1560
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2335
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Country | US
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Telephone | 772-266-7923
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Fax |
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Provider Business Mailing Address
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Address Line | 7113 KENSINGTON CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-3424
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Country | US
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Telephone | 561-236-1789
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH15185
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License Number State | FL
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