Provider Demographics
NPI:1194582528
Name:THE CARLILE THERAPY GROUP PLLC
Entity type:Organization
Organization Name:THE CARLILE THERAPY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLILE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMHC
Authorized Official - Phone:786-495-2627
Mailing Address - Street 1:5881 TOWN BAY DR APT 924
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5881 TOWN BAY DR APT 924
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-8720
Practice Address - Country:US
Practice Address - Phone:786-495-2627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty