Great Lakes Psychotherapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GREAT LAKES PSYCHOTHERAPY LLC

Practice address

2328 10TH Ave N Ste 500
Lake Worth Beach, FL 33461-6615

Phone

(561) 318-1474

NPI assigned

Apr 29, 2025

Organization subpart

No

Name

Ryan IsraelNPI 1508565003

Title

Manager

Phone

(561) 318-1474

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan A Israel

  • Social Worker
  • NPI 1508565003
  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 9, 2025.

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1114715083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 W MAPLE RD STE 101",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223717",
            "telephone_number": "561-318-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 500",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334616615",
            "telephone_number": "561-318-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-318-1474"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rainer Jean Goldberg
• Daniuska Gomez
• Melissa Gonzalez Garcia
• Priscilla Gonzalez
• Milaidy Gonzalo
• Karen Susan Grimes
• Andrea Hanner, LCSW
• Hello Sunshine Speech and Language Therapy, Inc.
• Hestia Healthcare at Home, LLC
• Heather Howard, LICSW

• All providers in Lake Worth Beach, FL
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.