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General NPI Number Information
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NPI Number | 1629511282
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Entity Type | Organization
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Legal Business Name | CENTER FOR CLINICAL PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 4851 W HILLSBORO BLVD STE A1
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4355
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Country | US
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Telephone | 561-463-2235
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Fax |
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Provider Business Mailing Address
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Address Line | 11089 HARBOUR SPRINGS CIR
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City | BOCA RATON
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State | FL
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Zip | 33428-1244
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Country | US
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Telephone | 561-463-2235
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Fax | 561-300-2950
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/ MANAGER
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Name | DR. ILENE KASKEL
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Credential |
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Telephone | 451-463-2235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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