Provider Demographics
NPI:1063788099
Name:PALM BEACH COUNSELING, LLC
Entity type:Organization
Organization Name:PALM BEACH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC
Authorized Official - Phone:561-214-0705
Mailing Address - Street 1:9325 GLADES RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3988
Mailing Address - Country:US
Mailing Address - Phone:561-214-0705
Mailing Address - Fax:
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-214-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty