=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245781434
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAYDEN & ASSOCIATES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2016
-----------------------------------------------------
Last Update Date | 10/22/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10042 SW 222ND ST
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33190-1563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-731-3034
-----------------------------------------------------
Fax | 305-402-2489
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10042 SW 222ND ST
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33190-1563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-731-3034
-----------------------------------------------------
Fax | 305-402-2489
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PAUL LAYDEN
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 305-731-3034
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PY4494
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------