Healthcare Provider Details

I. General information

NPI: 1346513751
Provider Name (Legal Business Name): BEST LIFE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W INDIANTOWN RD 107
JUPITER FL
33458-6830
US

IV. Provider business mailing address

1001 W INDIANTOWN RD 107
JUPITER FL
33458-6830
US

V. Phone/Fax

Practice location:
  • Phone: 561-745-8889
  • Fax: 561-354-0189
Mailing address:
  • Phone: 561-745-8889
  • Fax: 561-354-0189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH10942
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number1550AD982501
License Number StateFL

VIII. Authorized Official

Name: MRS. JENNIFER BENAIM
Title or Position: OWNER
Credential: LMHC
Phone: 561-745-8889