MEDICARE: BRIAN PATRICK DEPALMA LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	113054	CA
2	106H00000X	Marriage & Family Therapist	113054	CA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	106H00000X	Marriage & Family Therapist	4782	FL

General Provider Information

NPI Number	:	1093369639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PATRICK DEPALMA LMFT

Provider Business Mailing Address
First Line	:	5150 GARDEN HILLS CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-9130
Country	:	US
Telephone Number	:	845-551-5022
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 GARDEN HILLS CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-9130
Country	:	US
Telephone Number	:	845-551-5022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	10/25/2023

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