Healthcare Provider Details

I. General information

NPI: 1972862126
Provider Name (Legal Business Name): CULMER COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 SW 178TH WAY
PEMBROKE PINES FL
33029-4100
US

IV. Provider business mailing address

430 SW 178TH WAY
PEMBROKE PINES FL
33029-4100
US

V. Phone/Fax

Practice location:
  • Phone: 954-668-3406
  • Fax:
Mailing address:
  • Phone: 954-668-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberMH 10678
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH 10678
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PRIMROSE HUMPRHIES
Title or Position: THERAPIST/OWNER
Credential: MS, LMHC
Phone: 954-668-3406