Provider Demographics
NPI: | 1770936023 |
---|---|
Name: | REGINA PALMER DUBS LCSW LLC |
Entity type: | Organization |
Organization Name: | REGINA PALMER DUBS LCSW LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/PSYCHOTHERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | REGINA |
Authorized Official - Middle Name: | PALMER |
Authorized Official - Last Name: | DUBS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCSW |
Authorized Official - Phone: | 561-351-6441 |
Mailing Address - Street 1: | 13901 US HIGHWAY 1 |
Mailing Address - Street 2: | STE. 11 |
Mailing Address - City: | JUNO BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33408-1612 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 561-351-6441 |
Mailing Address - Fax: | 561-624-4772 |
Practice Address - Street 1: | 13901 US HIGHWAY 1 |
Practice Address - Street 2: | STE. 11 |
Practice Address - City: | JUNO BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33408-1612 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-351-6441 |
Practice Address - Fax: | 561-624-4772 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-07-21 |
Last Update Date: | 2016-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |