MEDICARE: PBC & ASSOCIATES MENTAL HEALTH SERVICES

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1164835856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PBC & ASSOCIATES MENTAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	4699 N FEDERAL HWY
Second Line	:	102F
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6510
Country	:	US
Telephone Number	:	954-210-6070
Fax Number	:	888-900-2325

Provider Business Practice Location Address
First Line	:	4699 N FEDERAL HWY
Second Line	:	102F
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6510
Country	:	US
Telephone Number	:	954-210-6070
Fax Number	:	888-900-2325

Authorized Official
Title or Position	:	CONSULTANT
Name	:	MR. ALAN DURETZ
Credential	:
Telephone Number	:	954-366-2700

Provider Enumeration Date	:	06/10/2014
Last Update Date	:	08/15/2014

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