Healthcare Provider Details

I. General information

NPI: 1982757894
Provider Name (Legal Business Name): SEBASTIAN COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 COMMERCE CENTER DR STE A
SEBASTIAN FL
32958-3136
US

IV. Provider business mailing address

735 COMMERCE CENTER DR STE A
SEBASTIAN FL
32958-3136
US

V. Phone/Fax

Practice location:
  • Phone: 772-589-4488
  • Fax: 772-589-9027
Mailing address:
  • Phone: 772-589-4488
  • Fax: 772-589-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMT1486
License Number StateFL

VIII. Authorized Official

Name: MS. STEPAHNIE BRAUN
Title or Position: VICE PRESIDENT
Credential: MA, LMFT
Phone: 772-589-4488