Healthcare Provider Details

I. General information

NPI: 1770376352
Provider Name (Legal Business Name): CONCEPTCORE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6047 KIMBERLY BLVD STE K
NORTH LAUDERDALE FL
33068-2820
US

IV. Provider business mailing address

6047 KIMBERLY BLVD STE K
NORTH LAUDERDALE FL
33068-2820
US

V. Phone/Fax

Practice location:
  • Phone: 888-508-1105
  • Fax:
Mailing address:
  • Phone: 888-508-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MANOUSHKA REMOGENE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 561-283-1244