Organization
PROFESSIONAL CLINICAL SERVICES OF WI 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID EDWARD SOMMERFELD (MANAGER)
(772) 494-2700
Entity
Organization
Contact information
Practice address
292 OLD DIXIE HWY, VERO BEACH, FL 32962-2947
(772) 494-2700
(772) 562-8127
Mailing address
292 OLD DIXIE HWY, VERO BEACH, FL 32962-2947
(772) 494-2700
(772) 562-8127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
102L00000X
Psychoanalyst
—
—
103T00000X
Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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