Provider Demographics
NPI:1568927705
Name:PEACEFUL PRANA THERAPY, LLC
Entity Type:Organization
Organization Name:PEACEFUL PRANA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:SUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-715-6050
Mailing Address - Street 1:4737 N OCEAN DR # 184
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2920
Mailing Address - Country:US
Mailing Address - Phone:954-715-6050
Mailing Address - Fax:
Practice Address - Street 1:2300 E OAKLAND PK BLVD
Practice Address - Street 2:STE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33306
Practice Address - Country:US
Practice Address - Phone:954-715-6050
Practice Address - Fax:866-757-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty