Provider Demographics
NPI: | 1821758376 |
---|---|
Name: | TRAUMA & ANXIETY COUNSELING OF GREATER PALM BEACHES INC. |
Entity Type: | Organization |
Organization Name: | TRAUMA & ANXIETY COUNSELING OF GREATER PALM BEACHES INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FOUNDER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KHOSROW |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SOLTANI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMHC |
Authorized Official - Phone: | 561-543-8993 |
Mailing Address - Street 1: | 1740 ANNANDALE CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | ROYAL PALM BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33411-6103 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1740 ANNANDALE CIR |
Practice Address - Street 2: | |
Practice Address - City: | ROYAL PALM BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33411-6103 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-543-8993 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-12-26 |
Last Update Date: | 2021-12-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |