Organization Name: | DELTONA COUNSELING ASSOCIATES, P.A. |
NPI Number: | 1689749160 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELLIOT MARC SHAMIS (PRESIDENT) |
Mailing Address: | 2851 Enterprise Rd Suite 102-b Debary |
State: | FL US |
Postal Code: | 327132786 |
Phone Number: | 3866686989 |
Fax Number: | 3866686989 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH2546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |