Healthcare Provider Details

I. General information

NPI: 1851581250
Provider Name (Legal Business Name): KEY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4134 GULF OF MEXICO DR 208C
LONGBOAT KEY FL
34228-2612
US

IV. Provider business mailing address

PO BOX 2233
SARASOTA FL
34230-2233
US

V. Phone/Fax

Practice location:
  • Phone: 941-228-8084
  • Fax:
Mailing address:
  • Phone: 941-228-8084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH 8909
License Number StateFL

VIII. Authorized Official

Name: ELIZABETH CUPO
Title or Position: PRINCIPAL
Credential: LPC
Phone: 941-228-2024