MEDICARE: TRAUMA COUNSELING OF FLORIDA, 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	:	1801567557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAUMA COUNSELING OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	4400 NW 73RD WAY
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-2164
Country	:	US
Telephone Number	:	954-520-4084
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 NW 73RD WAY
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-2164
Country	:	US
Telephone Number	:	954-520-4084
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	PAIGE LOREN SHIFFMAN
Credential	:
Telephone Number	:	850-736-4506

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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