MEDICARE: COMPREHENSIVE COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1174188197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	5333 SW 75TH ST APT H51
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-7449
Country	:	US
Telephone Number	:	352-514-0810
Fax Number	:

Provider Business Practice Location Address
First Line	:	5333 SW 75TH ST APT H51
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-7449
Country	:	US
Telephone Number	:	352-514-0810
Fax Number	:

Authorized Official
Title or Position	:	LMHC, REGISTERED AGENT, OWNER
Name	:	DEBORAH MICHELLE TROSTEN
Credential	:	LMHC
Telephone Number	:	352-514-0810

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	05/06/2019

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