Provider Demographics
NPI:1376829440
Name:CYNTHIA KRETSCHMER, LLC
Entity Type:Organization
Organization Name:CYNTHIA KRETSCHMER, LLC
Other - Org Name:PALM BEACH GARDENS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRETSCHMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-797-9909
Mailing Address - Street 1:2700 PGA BLVD
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2958
Mailing Address - Country:US
Mailing Address - Phone:561-797-9909
Mailing Address - Fax:
Practice Address - Street 1:2700 PGA BLVD
Practice Address - Street 2:SUITE 202A
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2958
Practice Address - Country:US
Practice Address - Phone:561-797-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ03FSOtherBCBSFL