Provider Demographics
NPI:1982772539
Name:HEAD, JAMES MICHAEL (MA, LPC, LCADC, CEAP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:HEAD
Suffix:
Gender:M
Credentials:MA, LPC, LCADC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S OCEAN BLVD APT 18
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6552
Mailing Address - Country:US
Mailing Address - Phone:561-886-8327
Mailing Address - Fax:
Practice Address - Street 1:1700 S OCEAN BLVD APT 18
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6552
Practice Address - Country:US
Practice Address - Phone:561-886-8327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00082100101YA0400X
NJ37PC00002000101YM0800X
PAPC005168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)