| Banyan Institute, Inc | |
|
11388 Okeechobee Blvd Royal Palm Beach FL 33411-8705 | |
| (561) 798-2310 | |
| (561) 798-2477 |
| Full Name | Banyan Institute, Inc |
|---|---|
| Speciality | Counselor |
| Location | 11388 Okeechobee Blvd, Royal Palm Beach, Florida |
| Authorized Official Name and Position | Lisa C Niebling (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5617982310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banyan Institute, Inc 11388 Okeechobee Blvd Royal Palm Beach FL 33411-8705 Ph: (561) 798-2310 | Banyan Institute, Inc 11388 Okeechobee Blvd Royal Palm Beach FL 33411-8705 Ph: (561) 798-2310 |
| NPI Number | 1033259783 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6608213681 |
|---|---|
| Medicare Enrollment ID | O20240326003214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033259783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH-4160 (Florida) | Primary |
| Provider Name | Lisa Cook Niebling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295853893 PECOS PAC ID: 7719322858 Enrollment ID: I20240326003462 |
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