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Organization

MINDWEALTH INSTITUTE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICK STEPHAN PH.D. (NEUROPSYCHOLOGIST)
(202) 297-0670
Entity
Organization

Contact information

Practice address
151 SE 3RD AVE APT 435, DELRAY BEACH, FL 33483-4683
(202) 297-0670
Mailing address
151 SE 3RD AVE SUITE 435, DELRAY BEACH, FL 33483
(202) 297-0670

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY9528
FL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY9528
FL
103TA0700X
Adult Development & Aging Psychologist
PY9528
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY9528
FL
103TF0200X
Forensic Psychologist
PY9528
FL
103TH0004X
Health Psychologist
PY9528
FL
103TR0400X
Rehabilitation Psychologist
PY9528
FL

Other

Enumeration date
08/17/2017
Last updated
07/21/2022
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