Provider Demographics
NPI:1326043480
Name:GLEICHER, LORI BETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:BETH
Last Name:GLEICHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 NW 48TH MNR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2104
Mailing Address - Country:US
Mailing Address - Phone:561-789-1661
Mailing Address - Fax:
Practice Address - Street 1:200 W PALMETTO PARK RD
Practice Address - Street 2:STE 306
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3759
Practice Address - Country:US
Practice Address - Phone:561-789-1661
Practice Address - Fax:954-346-6003
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6036103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54494Medicare ID - Type UnspecifiedMEDICARE NUMBER