Provider Demographics
NPI:1992121511
Name:BOCA RATON FAMILY COUNSELING,LLC
Entity type:Organization
Organization Name:BOCA RATON FAMILY COUNSELING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:KLASFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-441-9933
Mailing Address - Street 1:399 CAMINO GARDENS BLVD.
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432
Mailing Address - Country:US
Mailing Address - Phone:561-441-9933
Mailing Address - Fax:561-997-2533
Practice Address - Street 1:21301 POWERLINE RD STE 304
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2391
Practice Address - Country:US
Practice Address - Phone:561-441-9933
Practice Address - Fax:561-997-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW112021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty