Organization Name: | SPECTRUM COUNSELING SERVICES, LLC |
NPI Number: | 1780935148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GINA CHRISTINE MARTINELLI (CEO, LMHC) |
Mailing Address: | 103 E Montana Ave Bonifay |
State: | FL US |
Postal Code: | 324251706 |
Phone Number: | 8505471230 |
Fax Number: | 8505461230 |
NPI Enumeration Date: | 09/26/2012 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH10080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |