Provider Demographics
NPI:1861032138
Name:REACHLINK TELEBEHAVIORAL HEALTH SERVICES PA
Entity Type:Organization
Organization Name:REACHLINK TELEBEHAVIORAL HEALTH SERVICES PA
Other - Org Name:REACHLINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:833-732-2489
Mailing Address - Street 1:3651 FAU BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6489
Mailing Address - Country:US
Mailing Address - Phone:833-732-2489
Mailing Address - Fax:833-273-2242
Practice Address - Street 1:3651 FAU BLVD STE 400
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6489
Practice Address - Country:US
Practice Address - Phone:833-732-2489
Practice Address - Fax:833-273-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty