Healthcare Provider Details

I. General information

NPI: 1700629409
Provider Name (Legal Business Name): ANCHORAGE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 SW FEDERAL HWY STE 201B
STUART FL
34994-2972
US

IV. Provider business mailing address

1600 SE SAINT LUCIE BLVD APT 309
STUART FL
34996-4282
US

V. Phone/Fax

Practice location:
  • Phone: 732-236-5682
  • Fax:
Mailing address:
  • Phone: 732-236-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELISA P. SHELDON
Title or Position: OWNER
Credential: LCSW
Phone: 732-236-5682