Provider Demographics
NPI:1023571742
Name:ADVANCED PSYCHOLOGICAL SERVICES OF WESTON, LLC
Entity Type:Organization
Organization Name:ADVANCED PSYCHOLOGICAL SERVICES OF WESTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOCIU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-951-0932
Mailing Address - Street 1:2813 EXECUTIVE PARK DR STE 116
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2813 EXECUTIVE PARK DR STE 116
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3603
Practice Address - Country:US
Practice Address - Phone:954-951-0932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)