Provider Demographics
NPI:1952463168
Name:PSYCHOTHERAPY ASSOCIATES OF SOUTH FLORIDA, PA
Entity Type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF SOUTH FLORIDA, PA
Other - Org Name:AWARENESS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KADIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:561-638-9391
Mailing Address - Street 1:5425 10TH FAIRWAY DR
Mailing Address - Street 2:#3
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-7827
Mailing Address - Country:US
Mailing Address - Phone:561-638-9391
Mailing Address - Fax:561-431-2378
Practice Address - Street 1:849 SE 8TH AVE
Practice Address - Street 2:#2
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5615
Practice Address - Country:US
Practice Address - Phone:561-929-2343
Practice Address - Fax:561-431-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2004101YA0400X
FLMH-5461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty