Provider Demographics
NPI:1790131118
Name:MEANINGFUL MILESTONES
Entity Type:Organization
Organization Name:MEANINGFUL MILESTONES
Other - Org Name:RESET THERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:RASEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BCBA, ITDS
Authorized Official - Phone:561-325-6468
Mailing Address - Street 1:2029 OKEECHOBEE BLVD # 1145
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-4131
Mailing Address - Country:US
Mailing Address - Phone:561-325-6468
Mailing Address - Fax:
Practice Address - Street 1:17332 BALBOA POINT WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1015
Practice Address - Country:US
Practice Address - Phone:561-325-6468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
11519401251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty