Provider Demographics
NPI:1790002624
Name:CFB LCSW INC
Entity Type:Organization
Organization Name:CFB LCSW INC
Other - Org Name:AMERICA CBT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:FERNANDEZ
Authorized Official - Last Name:BETHART
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-707-7774
Mailing Address - Street 1:3501 KEYSER AVE
Mailing Address - Street 2:3
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2459
Mailing Address - Country:US
Mailing Address - Phone:954-707-7774
Mailing Address - Fax:
Practice Address - Street 1:3501 KEYSER AVE
Practice Address - Street 2:3
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2459
Practice Address - Country:US
Practice Address - Phone:954-707-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty