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General NPI Number Information
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NPI Number | 1952660102
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Entity Type | Organization
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Legal Business Name | JERI HOSICK, PH.D., LMHC, P.A.
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1402 ROYAL PALM BEACH BLVD
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1691
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Country | US
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Telephone | 561-792-7755
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Fax | 561-792-0399
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Provider Business Mailing Address
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Address Line | PO BOX 210746
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City | WEST PALM BEACH
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State | FL
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Zip | 33421-0746
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Country | US
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Telephone | 561-795-6296
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Fax | 561-792-0399
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Authorized Official
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Title or Position | PRESIDENT, VP, S, T
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Name | MRS. JERI HOSICK
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Credential | PH.D., LMHC
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Telephone | 561-795-6296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MH 2784
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License Number State | FL
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