Provider Demographics
NPI:1780819565
Name:ADVANCED PSYCHOEDUCATIONAL SERVICES
Entity Type:Organization
Organization Name:ADVANCED PSYCHOEDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPRING
Authorized Official - Middle Name:P
Authorized Official - Last Name:GAWKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-797-3219
Mailing Address - Street 1:15925 MEADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9027
Mailing Address - Country:US
Mailing Address - Phone:561-797-3219
Mailing Address - Fax:
Practice Address - Street 1:222 PROFESSIONAL WAY
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6391
Practice Address - Country:US
Practice Address - Phone:561-797-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW39391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty