Provider Demographics
NPI:1518361286
Name:DR.SETH LEVENTHAL,LLC
Entity Type:Organization
Organization Name:DR.SETH LEVENTHAL,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-622-4047
Mailing Address - Street 1:11380 PROSPERITY FARMS RD STE 210B
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3477
Mailing Address - Country:US
Mailing Address - Phone:561-622-4047
Mailing Address - Fax:561-622-4651
Practice Address - Street 1:11380 PROSPERITY FARMS RD STE 210B
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3477
Practice Address - Country:US
Practice Address - Phone:561-622-4047
Practice Address - Fax:561-622-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty