Provider Demographics
NPI:1881005239
Name:MARTY SEYLER LMHC CFLE P.A.
Entity Type:Organization
Organization Name:MARTY SEYLER LMHC CFLE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SEYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-596-2136
Mailing Address - Street 1:2001 PALM BEACH LAKES BLVD
Mailing Address - Street 2:STE 502G
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6510
Mailing Address - Country:US
Mailing Address - Phone:561-596-2136
Mailing Address - Fax:
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD
Practice Address - Street 2:STE 502G
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6510
Practice Address - Country:US
Practice Address - Phone:561-596-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4863101YM0800X
FL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty