MEDICARE: BIANCA SPIAK LMHC, CAP

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	MH 11347	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437490042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA SPIAK LMHC, CAP

Provider Business Mailing Address
First Line	:	2976 S MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-9200
Country	:	US
Telephone Number	:	561-465-1122
Fax Number	:

Provider Business Practice Location Address
First Line	:	7613 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467
Country	:	US
Telephone Number	:	561-465-1122
Fax Number	:

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

Provider Enumeration Date	:	03/06/2013
Last Update Date	:	03/06/2013

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