Provider Demographics
NPI:1306243449
Name:THE BOCA RATON CENTER FOR PSYCHOTHERAPY, PLLC
Entity type:Organization
Organization Name:THE BOCA RATON CENTER FOR PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MEL
Authorized Official - Last Name:LANDSMAN-WOHLSIFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-409-9701
Mailing Address - Street 1:370 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5816
Mailing Address - Country:US
Mailing Address - Phone:561-409-9701
Mailing Address - Fax:561-922-0371
Practice Address - Street 1:370 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5816
Practice Address - Country:US
Practice Address - Phone:561-409-9701
Practice Address - Fax:561-922-0371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 116991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty