Provider Demographics
NPI:1578157145
Name:RETHINK PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:RETHINK PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:352-580-0081
Mailing Address - Street 1:1803 SW 78TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3401
Mailing Address - Country:US
Mailing Address - Phone:352-514-6346
Mailing Address - Fax:
Practice Address - Street 1:500 E UNIVERSITY AVE STE C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-3458
Practice Address - Country:US
Practice Address - Phone:352-514-6346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty