KETAMINE TREATMENT CENTERS OF PRINCETON, LLC (NPI# 1114563434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114563434 |
| Entity Type | Organization |
| Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Practice Address |
1411 N Flagler Dr Ste 4700 West Palm Beach FL 33401-3408 |
| Mailing Address |
800 Bunn Dr Ste 304 Princeton NJ 08540-1968 |
| Practice Telephone | 8885668774 |
| Mailing Telephone | 8885668774 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | STEVEN P. LEVINE (MANAGING MEMBER) |
| Authorized Official Telephone | 6096514429 |
| Is Organization Subpart | Y |
| Parent Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Actify Neurotherapies | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679119994 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 9800 Falls Rd Ste 105, Potomac, MD 20854-3939 | 2019-11-21 |
| 1538705835 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 357 S Gulph Rd Ste 260, King of Prussia, PA 19406-3174 | 2019-11-21 |
| 1730725052 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 91 S Jefferson Rd Ste 301, Whippany, NJ 07981-1037 | 2019-11-21 |
| 1174169478 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 1122 Kenilworth Dr Ste 418, Towson, MD 21204-2148 | 2019-11-21 |
| 1780174482 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 12 E 44th St Fl 6, New York, NY 10017-3624 | 2018-05-17 |
| 1609288604 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 800 Bunn Dr, Suite 304, Princeton, NJ 08540-1968 | 2014-05-24 |
| Street Address |
1411 N FLAGLER DR STE 4700 |
| City | WEST PALM BEACH |
| State | FL |
| Zip Code | 33401-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598371882 | Curt David Miller | Nurse Practitioner | 5300 East Avenue West Palm Beach Fl, West Palm Beach, FL 33401 | 2020-09-22 |
| 1699338152 | Carly N Lupo | Social Worker | 700 S Rosemary Ave, Suite 204 Ofc 101, West Palm Beach, FL 33401 | 2019-04-19 |
| 1740752625 | Latasha Harper | Specialist | 512 N St, West Palm Beach, FL 33401 | 2018-12-17 |
| 1124595640 | Elin Nordegren | Counselor | 1555 Palm Beach Lakes Blvd Suite 1560, West Palm Beach, FL 33401 | 2018-11-02 |
| 1205318664 | Phanette Turene | Behavior Technician | 1720 N Congress Ave Apt B207, West Palm Beach, FL 33401 | 2018-09-02 |
| 1790277002 | Ashley Zarda | Developmental Therapist | 253 8th St, West Palm Beach, FL 33401 | 2018-06-01 |
| 1487162988 | Pinnacle Counseling Service Pllc | Social Worker | 1900 S Olive Avenue, West Palm Beach, FL 33401 | 2018-01-18 |
| 1245754027 | Patricia Caroscio | Dental Hygienist | 800 Clematis Street, West Palm Beach, FL 33401 | 2017-08-02 |
| 1255852562 | Dermnow Pa | Dermatology | 1500 N Flasler Dr #, 101, West Palm Beach, FL 33401 | 2017-06-28 |
| 1699204289 | Edward Gerardo Ortiz | Counselor | 1639 Forum Place Suite #7, West Palm Beach, West Palm Beach, FL 33401 | 2017-06-07 |
| Find all providers in zip 33401 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305598 | Wp Blue Horizon Psychiatry LLC | Psychiatry & Neurology | 7721 N Military Trl Ste 1-2, West Palm Beach, FL 33410-7429 | 2017-06-05 |
| 1952760944 | Desert Rose Fl LLC | Psychiatry & Neurology | 1639 Forum Pl # 1, West Palm Beach, FL 33401-2330 | 2016-02-18 |
| 1629458419 | Brett Flanagan | Psychiatry & Neurology | 4631 N Congress Ave Ste 110, West Palm Beach, FL 33407-3238 | 2015-06-05 |
| 1275923377 | Emilio J Duboy, Md | Psychiatry & Neurology | 2051 45th St Ste 209, West Palm Beach, FL 33407-2014 | 2015-01-27 |
| 1114276235 | Duy Dinh Nguyen | Psychiatry & Neurology | 317 N Lakeside Ct, West Palm Beach, FL 33407-6538 | 2012-09-05 |
| 1922380914 | Joseph Frank Lalia | Psychiatry & Neurology | 1805 N Flagler Dr Apt 304, West Palm Beach, FL 33407-6548 | 2011-09-15 |
| 1952692097 | Scott S. Kunce | Psychiatry & Neurology | 560 Village Blvd Ste 150, West Palm Beach, FL 33409 | 2011-04-24 |
| 1134420136 | Clinical Associates of The Palm Beaches | Psychiatry & Neurology | 1920 Palm Beach Lakes Blvd Ste 102, West Palm Beach, FL 33409-3505 | 2010-11-06 |
| 1992015184 | Piere Jacob Montrose M D Pa | Psychiatry & Neurology | 5762 Okeechobee Blvd, Suite 607, West Palm Beach, FL 33417-4343 | 2010-10-21 |
| 1013167170 | Louis Theodore Joseph | Psychiatry & Neurology | 302 E Lakewood Rd, West Palm Beach, FL 33405 | 2008-09-25 |
| Find all providers in WEST PALM BEACH | ||||
| City | WEST PALM BEACH |
| Zip Code | 33401 |
Please comment or provide details below to improve the information on KETAMINE TREATMENT CENTERS OF PRINCETON, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.