Provider Demographics
NPI:1659554491
Name:PSYCHODYNANIC CONSULTING INC.
Entity Type:Organization
Organization Name:PSYCHODYNANIC CONSULTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:305-801-7232
Mailing Address - Street 1:19420 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5809
Mailing Address - Country:US
Mailing Address - Phone:305-801-7232
Mailing Address - Fax:
Practice Address - Street 1:2645 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 140
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3624
Practice Address - Country:US
Practice Address - Phone:305-801-7232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-16
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7484261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)