Provider Demographics
NPI:1922512136
Name:RKG PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:RKG PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:GORCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-648-3974
Mailing Address - Street 1:2900 N UNIVERSITY DR STE 30
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5083
Mailing Address - Country:US
Mailing Address - Phone:954-648-3974
Mailing Address - Fax:
Practice Address - Street 1:2900 N UNIVERSITY DR STE 30
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5083
Practice Address - Country:US
Practice Address - Phone:954-648-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13360261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health