Delray Beach Intensive Outpatient Program LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW3546 Issued in FL

Legal business name

DELRAY BEACH INTENSIVE OUTPATIENT PROGRAM LLC

Practice address

301 W Atlantic Ave
Suite 0-5
Delray Beach, FL 33444-3687

Phone

(561) 894-6010

Fax

(305) 647-0680

NPI assigned

Jul 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allen Sergio McCormick, PH.D, LCSW, CAPNPI 1225035744

Title

President

Phone

(561) 894-6010

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Allen Sergio McCormick, LCSW

  • Clinical Social Worker
  • Palm Beach Gardens, FL
  • NPI 1225035744
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1821343146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W ATLANTIC AVE",
            "address_2": "SUITE 0-5",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334443687",
            "telephone_number": "561-894-6010",
            "fax_number": "305-647-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W ATLANTIC AVE",
            "address_2": "SUITE 0-5",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334443687",
            "telephone_number": "561-894-6010",
            "fax_number": "305-647-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELRAY BEACH INTENSIVE OUTPATIENT PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-894-6010",
        "authorized_official_credential": "PH.D, LCSW, CAP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Delray Beach ASC, LLC
• Delray Beach Dialysis Center LLC
• Delray Beach Outpatient Services, LLC
• Delray Beach Surgical Suites, LLC
• Delray Beach Villa, LLC
• Delray Beach Wellness and Rehab
• Delray Beach Wellness Center LLC

• Clinical Social Worker in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.