Healthcare Provider Details
I. General information
NPI: 1538424130
Provider Name (Legal Business Name): URBAN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2012
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1130 SE 18TH PL SUITE 400
OCALA FL
34471-5422
US
IV. Provider business mailing address
1130 SE 18TH PL SUITE 400
OCALA FL
34471-5422
US
V. Phone/Fax
- Phone: 352-390-6659
- Fax: 352-390-8756
- Phone: 352-390-6659
- Fax: 352-390-8756
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH9889 |
| License Number State | FL |
VIII. Authorized Official
Name:
JOYCE
K
URBAN
Title or Position: OWNER
Credential: M.A., L.M.H.C.
Phone: 352-390-6659