Provider Demographics
NPI:1407297443
Name:BEREAVEMENT SPECIALISTS
Entity Type:Organization
Organization Name:BEREAVEMENT SPECIALISTS
Other - Org Name:CROSSING BRIDGES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CT
Authorized Official - Phone:561-574-7052
Mailing Address - Street 1:321 SANDTREE DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1520
Mailing Address - Country:US
Mailing Address - Phone:561-574-7052
Mailing Address - Fax:
Practice Address - Street 1:5436 COURTNEY CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-1248
Practice Address - Country:US
Practice Address - Phone:561-574-7052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-06
Last Update Date:2013-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW68231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty