Provider Demographics
NPI:1265298871
Name:SEA GLASS MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:SEA GLASS MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALATI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-301-5410
Mailing Address - Street 1:17801 38TH RD N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3632
Mailing Address - Country:US
Mailing Address - Phone:561-301-5410
Mailing Address - Fax:
Practice Address - Street 1:12765 FOREST HILL BLVD STE 1309
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4781
Practice Address - Country:US
Practice Address - Phone:561-301-5410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)