Provider Demographics
NPI:1740763077
Name:KERRI IFILL, LMHC, PA
Entity Type:Organization
Organization Name:KERRI IFILL, LMHC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:AVERY
Authorized Official - Last Name:IFILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-899-8018
Mailing Address - Street 1:15856 FORSYTHIA CIR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-9170
Mailing Address - Country:US
Mailing Address - Phone:954-899-8018
Mailing Address - Fax:
Practice Address - Street 1:2255 GLADES RD STE 324A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8571
Practice Address - Country:US
Practice Address - Phone:954-899-8018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty