Kathy Leigh Back | Lake Worth, FL • PECOS Search

Kathy Leigh Back

Counselor

Behavioral Health & Social Service Providers

8461 Lake Worth Rd Ste 234, Lake Worth, FL 33467-2474

PECOS Enrollment

Based on the most recent information from CMS, provider Kathy Leigh Back does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1407416209
Provider Type
Individual
Full Name
Back, Kathy Leigh
Title
Ms.
Credential
LMHC

Gender
Female
Sole Proprietor
No
Enumeration Date
6/14/2019
Last Updated
6/14/2019

Contact Information

Practice Location

8461 Lake Worth Rd Ste 234, Lake Worth, FL 33467-2474

(561) 828-8075

Mailing Location

8461 Lake Worth Rd Ste 234, Lake Worth, FL 33467-2474

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License MH4979 Florida