Healthcare Provider Details

I. General information

NPI: 1831012301
Provider Name (Legal Business Name): CAPE CORAL COUNSELING PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5793 CAPE HARBOUR DR APT 1114
CAPE CORAL FL
33914-8643
US

IV. Provider business mailing address

5793 CAPE HARBOUR DR APT 1114
CAPE CORAL FL
33914-8643
US

V. Phone/Fax

Practice location:
  • Phone: 978-409-0391
  • Fax:
Mailing address:
  • Phone: 978-409-0391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KAREN LECLAIRE
Title or Position: OWNER
Credential:
Phone: 978-409-0391