Organization Name: | COUNSELING CONCEPTS, PA |
NPI Number: | 1053390476 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LOTTIE M. SUSKIEWICH (PRESIDENT) |
Mailing Address: | 312 W 1st St #107 Sanford |
State: | FL US |
Postal Code: | 327711231 |
Phone Number: | 4073021774 |
Fax Number: | 4073021780 |
NPI Enumeration Date: | 01/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH6541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |