Provider Demographics
NPI:1023310406
Name:HEALTH PSYCHOLOGY OF PALM BEACH LLC
Entity type:Organization
Organization Name:HEALTH PSYCHOLOGY OF PALM BEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLONIMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-373-0664
Mailing Address - Street 1:712 ARDMORE RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7630
Mailing Address - Country:US
Mailing Address - Phone:561-373-0664
Mailing Address - Fax:
Practice Address - Street 1:712 ARDMORE RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7630
Practice Address - Country:US
Practice Address - Phone:561-373-0664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8071103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK160483OtherMEDICARE ID TYPE UNSPECIFIED