| Great Lakes Psychotherapy Llc | |
|
2328 10th Ave N Ste 500 Lake Worth Beach FL 33461-6615 | |
| (561) 318-1474 | |
| Not Available |
| Full Name | Great Lakes Psychotherapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2328 10th Ave N Ste 500, Lake Worth Beach, Florida |
| Authorized Official Name and Position | Ryan Israel (MANAGER) |
| Authorized Official Contact | 5613181474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Psychotherapy Llc 5640 W Maple Rd Ste 101 W Bloomfield MI 48322-3717 Ph: (561) 318-1474 | Great Lakes Psychotherapy Llc 2328 10th Ave N Ste 500 Lake Worth Beach FL 33461-6615 Ph: (561) 318-1474 |
| NPI Number | 1114715083 |
|---|---|
| Provider Enumeration Date | 04/29/2025 |
| Last Update Date | 06/09/2025 |
| Certification Date | 06/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114715083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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