1295146900 NPI number — MY COUNSELING CONNECTIONS INC.

Table of Contents

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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