Provider Demographics
NPI:1720504459
Name:HARILAL, RESHMA (MA, CMHP)
Entity Type:Individual
Prefix:MRS
First Name:RESHMA
Middle Name:
Last Name:HARILAL
Suffix:
Gender:F
Credentials:MA, CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 N MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2972
Mailing Address - Country:US
Mailing Address - Phone:561-932-4665
Mailing Address - Fax:
Practice Address - Street 1:2215 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2972
Practice Address - Country:US
Practice Address - Phone:561-932-4665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82-2479160OtherFEDERAL TAX ID