Provider Demographics
NPI:1588974703
Name:ANN MCNEIL PSYCHOTHERAPY, INC.
Entity type:Organization
Organization Name:ANN MCNEIL PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-314-9879
Mailing Address - Street 1:314 SE 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-8628
Mailing Address - Country:US
Mailing Address - Phone:561-314-9879
Mailing Address - Fax:561-740-4075
Practice Address - Street 1:8000 N FEDERAL HWY
Practice Address - Street 2:SUITE 218
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1680
Practice Address - Country:US
Practice Address - Phone:561-314-9879
Practice Address - Fax:561-740-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW87581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBX940AMedicare UPIN