1295146900 NPI number — MY COUNSELING CONNECTIONS INC.

Table of content: (NPI 1295146900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295146900 NPI number — MY COUNSELING CONNECTIONS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MY COUNSELING CONNECTIONS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295146900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8715 SW 57 STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COOPER CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-839-0106
Provider Business Mailing Address Fax Number:
954-374-6274

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
817 S UNIVERSITY DRIVE, SUITE #121
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33324-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-477-7455
Provider Business Practice Location Address Fax Number:
954-374-6274
Provider Enumeration Date:
05/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BERMAN
Authorized Official First Name:
TAMAR
Authorized Official Middle Name:
LIMOR
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
954-839-0106

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH8967 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MH8967 . This is a "MENTAL HEALTH LICENSE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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