Provider Demographics
NPI:1275627960
Name:STANLEY B SEIDMAN PHD PA D B A ASSOCIATES IN BEHAVIORAL COUNSELING
Entity Type:Organization
Organization Name:STANLEY B SEIDMAN PHD PA D B A ASSOCIATES IN BEHAVIORAL COUNSELING
Other - Org Name:ASSOCIATES IN BEHAVIORAL COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-742-8400
Mailing Address - Street 1:449 BONTONA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2419
Mailing Address - Country:US
Mailing Address - Phone:954-742-8400
Mailing Address - Fax:954-742-0918
Practice Address - Street 1:449 BONTONA AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2419
Practice Address - Country:US
Practice Address - Phone:954-742-8400
Practice Address - Fax:954-742-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98543Medicare PIN