Provider Demographics
NPI:1205667946
Name:SIENNA PSYCHOLOGY OF THE PALM BEACHES, LLC
Entity type:Organization
Organization Name:SIENNA PSYCHOLOGY OF THE PALM BEACHES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBLASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-710-6008
Mailing Address - Street 1:4645 MEDITERRANEAN CIR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1002
Mailing Address - Country:US
Mailing Address - Phone:561-710-6008
Mailing Address - Fax:
Practice Address - Street 1:4362 NORTHLAKE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6269
Practice Address - Country:US
Practice Address - Phone:561-710-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty