Provider Demographics
NPI:1891499554
Name:ATHERA BEHAVIORAL HEALTH P.A.
Entity Type:Organization
Organization Name:ATHERA BEHAVIORAL HEALTH P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-670-3322
Mailing Address - Street 1:271 33RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3365
Mailing Address - Country:US
Mailing Address - Phone:954-899-0808
Mailing Address - Fax:
Practice Address - Street 1:110 N FEDERAL HWY STE 204
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4300
Practice Address - Country:US
Practice Address - Phone:954-899-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty