# DIRECT CLINICS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DIRECT CLINICS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689329922
- **Authorized official:** MR. WALLACE DE ROTHSMAN (CEO)
- **Authorized official phone:** (650) 797-8441

## Contact information

- **Practice address:** 8980 S FEDERAL HWY STE 100B, PORT ST LUCIE, FL 34952-3482
- **Practice address phone:** (888) 484-2466
- **Mailing address:** 2221 NE 164TH ST STE 296, AVENTURA, FL 33160-3703
- **Mailing address phone:** (888) 484-2466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2022
- **Last updated:** 04/06/2022