Provider Demographics
NPI:1023555307
Name:GHEZZI PSYCHOTHERAPY SERVICES
Entity Type:Organization
Organization Name:GHEZZI PSYCHOTHERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:GHEZZI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-317-3978
Mailing Address - Street 1:1881 NE 26TH ST
Mailing Address - Street 2:70
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1416
Mailing Address - Country:US
Mailing Address - Phone:954-317-3978
Mailing Address - Fax:954-909-4480
Practice Address - Street 1:1881 NE 26TH ST
Practice Address - Street 2:70
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1416
Practice Address - Country:US
Practice Address - Phone:954-317-3978
Practice Address - Fax:954-909-4480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty