Healthcare Provider Details

I. General information

NPI: 1194850636
Provider Name (Legal Business Name): COUNSELING SERVICE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 N FEDERAL HWY SUITE 165-B
BOCA RATON FL
33487-1657
US

IV. Provider business mailing address

7601 N FEDERAL HWY SUITE 165-B
BOCA RATON FL
33487-1657
US

V. Phone/Fax

Practice location:
  • Phone: 561-995-9500
  • Fax: 561-995-9510
Mailing address:
  • Phone: 561-995-9500
  • Fax: 561-995-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA HEARN
Title or Position: DIRECTOR
Credential: LMHC, CAP, SAP
Phone: 561-995-9500