Organization
BEACH THERAPY CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LANG PHD (OWNER)
(201) 675-7151
Entity
Organization
Contact information
Practice address
12701 CINQUETERRE DR, VENICE, FL 34293-4076
(201) 675-7151
Mailing address
12701 CINQUETERRE DR, VENICE, FL 34293-4076
(201) 675-7151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19212
LCSW
FL
Enumeration date
08/29/2022
Last updated
09/14/2022
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