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General NPI Number Information
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NPI Number | 1881776235
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Entity Type | Organization
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Legal Business Name | D/B/A EAST BOCA COUNSELING
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5820 N. FEDERAL HWY. SUITE D-3
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City | BOCA RATON
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State | FL
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Zip | 33487-1432
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Country | US
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Telephone | 561-241-7784
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Fax | 561-241-9784
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Provider Business Mailing Address
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Address Line | 5820 N. FEDERAL HWY. SUITE D-3
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City | BOCA RATON
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State | FL
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Zip | 33487-1432
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Country | US
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Telephone | 561-241-7784
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Fax | 561-241-9784
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Authorized Official
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Title or Position | ELIZABETH A. RADCLIFFE
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Name | MS. ELIZABETH A. RADCLIFFE
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Credential | LCSW, CAP
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Telephone | 561-241-7784
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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 | SW5705
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License Number State | FL
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