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General NPI Number Information
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NPI Number | 1790131118
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Entity Type | Organization
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Legal Business Name | MEANINGFUL MILESTONES
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 17332 BALBOA POINT WAY
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City | BOCA RATON
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State | FL
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Zip | 33487-1015
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Country | US
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Telephone | 561-325-6468
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Fax |
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Provider Business Mailing Address
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Address Line | 2029 OKEECHOBEE BLVD # 1145
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-4131
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Country | US
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Telephone | 561-325-6468
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | STEPHANIE ELIZABETH RASEL
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Credential | LCSW, BCBA, ITDS
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Telephone | 561-325-6468
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 11519401
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License Number State |
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