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General NPI Number Information
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NPI Number | 1487274817
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Entity Type | Individual
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Provider Name | MICHAEL L PRICE LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 505 S FEDERAL HWY STE 2
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4147
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Country | US
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Telephone | 833-822-6504
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Fax |
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Provider Business Mailing Address
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Address Line | 4502 N FEDERAL HWY APT 215
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-6556
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Country | US
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Telephone | 954-663-7657
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW17047
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License Number State | FL
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