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General NPI Number Information
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NPI Number | 1497471734
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY ATTANASIO LMHC
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Gender | Male
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 4020 LAKE WORTH ROAD
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City | PALM SPRINGS
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-444-3512
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Fax | 561-473-9426
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Provider Business Mailing Address
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Address Line | 531 S FEDERAL HWY APT 13
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City | LAKE WORTH
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State | FL
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Zip | 33460-4680
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Country | US
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Telephone | 561-444-3512
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | IMH20906
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH22102
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License Number State | FL
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