Healthcare Provider Details

I. General information

NPI: 1821762683
Provider Name (Legal Business Name): INGRAM COUNSELING & PSYCHOTHERAPY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 S CONGRESS AVE STE 1F
PALM SPRINGS FL
33406-7667
US

IV. Provider business mailing address

2324 S CONGRESS AVE STE 1F
PALM SPRINGS FL
33406-7667
US

V. Phone/Fax

Practice location:
  • Phone: 561-601-0235
  • Fax:
Mailing address:
  • Phone: 561-601-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHIRLEYANN INGRAM KING
Title or Position: MENTAL HEALTH COUNSELOROWNER
Credential: MA. LMHC. MCAP
Phone: 561-601-0235