Basic Information
Provider Information
NPI: 1396068953
EntityType: 2
ReplacementNPI:  
OrganizationName: MULTILINGUAL PSYCHOTHERAPY CENTER
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1639 FORUM PL
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334012330
CountryCode: US
TelephoneNumber: 5617128821
FaxNumber: 5617128070
Practice Location
Address1: 1639 FORUM PL
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334012330
CountryCode: US
TelephoneNumber: 5617128821
FaxNumber: 5617128070
Other Information
ProviderEnumerationDate: 03/10/2010
LastUpdateDate: 03/10/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: UNSWORTH
AuthorizedOfficialFirstName: TOM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CLINICAL SUPERVISOR
AuthorizedOfficialTelephone: 5617128821
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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