Provider Demographics
NPI:1629511282
Name:CENTER FOR CLINICAL PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:CENTER FOR CLINICAL PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:451-463-2235
Mailing Address - Street 1:11089 HARBOUR SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1244
Mailing Address - Country:US
Mailing Address - Phone:561-463-2235
Mailing Address - Fax:561-300-2950
Practice Address - Street 1:4851 W HILLSBORO BLVD STE A1
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4355
Practice Address - Country:US
Practice Address - Phone:561-463-2235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty