Provider Demographics
NPI:1902603566
Name:PSYCHOTHERAPY 101 LLC
Entity type:Organization
Organization Name:PSYCHOTHERAPY 101 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOSSENS ALAYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-440-7678
Mailing Address - Street 1:1127 ROYAL PALM BEACH BLVD # 128
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1641
Mailing Address - Country:US
Mailing Address - Phone:561-440-7678
Mailing Address - Fax:
Practice Address - Street 1:1127 ROYAL PALM BEACH BLVD # 128
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1641
Practice Address - Country:US
Practice Address - Phone:561-440-7678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty