Basic Information
| Provider Information | |||||||||
| NPI: | 1164551842 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVENTHAL | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11380 PROSPERITY FARMS RD | ||||||||
| Address2: | STE 210B | ||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616224047 | ||||||||
| FaxNumber: | 5616224651 | ||||||||
| Practice Location | |||||||||
| Address1: | 11380 PROSPERITY FARMS RD | ||||||||
| Address2: | STE 210B | ||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616224047 | ||||||||
| FaxNumber: | 5616224651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 05/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PY5320 | FL | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.