Healthcare Provider Details

I. General information

NPI: 1114129160
Provider Name (Legal Business Name): WEST BROWARD COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12505 ORANGE DR SUITE 907
DAVIE FL
33330-4300
US

IV. Provider business mailing address

12505 ORANGE DR SUITE 907
DAVIE FL
33330-4300
US

V. Phone/Fax

Practice location:
  • Phone: 954-358-5788
  • Fax: 954-358-5790
Mailing address:
  • Phone: 954-358-5788
  • Fax: 954-358-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAWNDA BURNS
Title or Position: OWNER
Credential: LMHC, CAP
Phone: 954-358-5788