Provider Demographics
NPI:1336897743
Name:TREIBER, PHILLIP (MS, MCAP, NCC)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:TREIBER
Suffix:
Gender:M
Credentials:MS, MCAP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 ALTA MEADOWS LN APT 910
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1159
Mailing Address - Country:US
Mailing Address - Phone:516-510-8508
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5195
Practice Address - Country:US
Practice Address - Phone:516-510-8508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)