Provider Demographics
NPI:1992147417
Name:SL THERAPY, INC.
Entity type:Organization
Organization Name:SL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LEITNER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:954-437-7072
Mailing Address - Street 1:2250 NW 136TH AVE
Mailing Address - Street 2:#104
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028
Mailing Address - Country:US
Mailing Address - Phone:954-437-7072
Mailing Address - Fax:954-212-5757
Practice Address - Street 1:2250 NW 136TH AVE
Practice Address - Street 2:#104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-437-7072
Practice Address - Fax:954-212-5757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00044541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty