Healthcare Provider Details

I. General information

NPI: 1508246554
Provider Name (Legal Business Name): CENTRO DE CONSEJERIA PALABRA DE SABIDURIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 N FLAMINGO RD STE 308
PEMBROKE PINES FL
33028-1033
US

IV. Provider business mailing address

1984 NW 179TH AVE
PEMBROKE PINES FL
33029-3052
US

V. Phone/Fax

Practice location:
  • Phone: 954-999-4786
  • Fax:
Mailing address:
  • Phone: 305-333-0910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENIO FIGUEROA
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 305-333-0910