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General NPI Number Information
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NPI Number | 1710607635
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Entity Type | Organization
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Legal Business Name | POSITIVE TRANSFORMATION PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 11828 NW 13TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4345
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Country | US
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Telephone | 954-627-2149
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Fax | 954-212-8154
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Provider Business Mailing Address
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Address Line | 11828 NW 13TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4345
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Country | US
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Telephone | 954-627-2149
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN & CEO
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Name | DR. CARL-PHILIPPE PIERRE-PAUL
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Credential | PSY.D.
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Telephone | 516-418-2673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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