Provider Demographics
NPI:1013527431
Name:BE FREE STAY FREE FAMILY & INDIVIDUAL THERAPY LLC
Entity Type:Organization
Organization Name:BE FREE STAY FREE FAMILY & INDIVIDUAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LMHC
Authorized Official - Phone:561-377-2373
Mailing Address - Street 1:640 CLEMATIS ST UNIT 2474
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33402-5104
Mailing Address - Country:US
Mailing Address - Phone:561-377-2373
Mailing Address - Fax:
Practice Address - Street 1:3626 WHITEHALL DR APT 206
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1065
Practice Address - Country:US
Practice Address - Phone:561-377-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health