Provider Demographics
NPI:1588923379
Name:BROWARD PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BROWARD PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNJANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAS-GALVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-374-4747
Mailing Address - Street 1:1941 NW 150TH AVE
Mailing Address - Street 2:104
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2874
Mailing Address - Country:US
Mailing Address - Phone:877-309-7271
Mailing Address - Fax:
Practice Address - Street 1:1941 NW 150TH AVE
Practice Address - Street 2:104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2874
Practice Address - Country:US
Practice Address - Phone:877-309-7271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0405X
FLPY7981103T00000X
FLPY8285103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty