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General NPI Number Information
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NPI Number | 1902603566
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY 101 LLC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1127 ROYAL PALM BEACH BLVD # 128
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1641
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Country | US
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Telephone | 561-440-7678
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 ROYAL PALM BEACH BLVD # 128
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1641
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Country | US
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Telephone | 561-440-7678
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEPHANIE GOOSSENS ALAYON
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Credential |
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Telephone | 561-440-7678
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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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