Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Identity Development South Ltd Inc

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1295894301

Center for Identity Development South Ltd Inc is a Mental Health Clinic/Center (Including Community Mental Health Center) in Coconut Creek, Florida. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4855 W Hillsboro Blvd Ste B1
Coconut Creek, FL 33073-4356
Phone: (954) 345-5525
Fax: (954) 977-4978
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X

Record details

NPI number1295894301
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michele Lanese — President Center For Identity Devel · (954) 345-5525
NPI enumeratedDecember 6, 2006
Last updated in NPPESJuly 29, 2014
Mailing address4855 W Hillsboro Blvd, Suite B1, Coconut Creek, FL 33073-4356

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