Basic Information
| Provider Information | |||||||||
| NPI: | 1518361286 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR.SETH LEVENTHAL,LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11380 PROSPERITY FARMS RD STE 210B | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616224047 | ||||||||
| FaxNumber: | 5616224651 | ||||||||
| Practice Location | |||||||||
| Address1: | 11380 PROSPERITY FARMS RD STE 210B | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616224047 | ||||||||
| FaxNumber: | 5616224651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2014 | ||||||||
| LastUpdateDate: | 05/19/2020 | ||||||||
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| AuthorizedOfficialLastName: | LEVENTHAL | ||||||||
| AuthorizedOfficialFirstName: | SETH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MGR | ||||||||
| AuthorizedOfficialTelephone: | 5616224047 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
| NPICertificationDate: | 05/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PY5320 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.