Organization Name: | ACTIVE COUNSELING CENTER, LLC |
NPI Number: | 1174935944 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GISELLE APOSTEL (MGR) |
Mailing Address: | 201 6th Ave Indialantic |
State: | FL US |
Postal Code: | 329033303 |
Phone Number: | 3212968338 |
Fax Number: | 3218373706 |
NPI Enumeration Date: | 05/28/2014 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW6728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |