Provider Demographics
NPI:1366768061
Name:PLAYTON, NICOLE RENEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:RENEE
Last Name:PLAYTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8754
Mailing Address - Country:US
Mailing Address - Phone:561-844-3556
Mailing Address - Fax:
Practice Address - Street 1:1720 E TIFFANY DR STE 102
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3235
Practice Address - Country:US
Practice Address - Phone:561-844-3556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006340100Medicaid