Provider Demographics
NPI:1477154631
Name:MACCHIONE PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:MACCHIONE PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MACCHIONE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-895-3266
Mailing Address - Street 1:328 NW 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7068
Mailing Address - Country:US
Mailing Address - Phone:954-895-3266
Mailing Address - Fax:
Practice Address - Street 1:328 NW 97TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7068
Practice Address - Country:US
Practice Address - Phone:954-895-3266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health