Healthcare Provider Details

I. General information

NPI: 1295996072
Provider Name (Legal Business Name): BEFORE, BEYOND & NOW: PROFESSIONAL COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 12TH AVE
PENSACOLA FL
32501-3308
US

IV. Provider business mailing address

1150 N 12TH AVE
PENSACOLA FL
32501-3308
US

V. Phone/Fax

Practice location:
  • Phone: 850-208-4015
  • Fax:
Mailing address:
  • Phone: 850-208-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH9330
License Number StateFL

VIII. Authorized Official

Name: MS. SHANNON N ARSENAULT
Title or Position: MANAGING MEMBER
Credential: M.A.
Phone: 850-208-4015