| Organization Name: | COUNSELING COTTAGE LLC |
| NPI Number: | 1346607660 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROXANNE D PRATT (OWNER) |
| Mailing Address: | 7313 Merchant Ct Suite L Lakewood Ranch |
| State: | FL US |
| Postal Code: | 342408437 |
| Phone Number: | 9413503009 |
| Fax Number: | 6784206620 |
| NPI Enumeration Date: | 01/16/2016 |
| NPI Last Update Date: | 01/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | MH 13545 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |