Organization
ADAPTIVE MIND PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY LUPO LCSW, BCN (CEO)
(561) 246-5063
Entity
Organization
Contact information
Practice address
700 S ROSEMARY AVE STE 204, WEST PALM BEACH, FL 33401-6310
(561) 246-5063
Mailing address
700 S ROSEMARY AVE STE 204, WEST PALM BEACH, FL 33401-6310
(561) 246-5063
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103557300
—
FL
Enumeration date
01/06/2020
Last updated
08/11/2020
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