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General NPI Number Information
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NPI Number | 1053462119
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Entity Type | Organization
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Legal Business Name | LIFELINE COUNSELING, INC.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10406 TAFT ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2819
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Country | US
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Telephone | 954-436-3880
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Fax | 954-436-3881
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Provider Business Mailing Address
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Address Line | 10406 TAFT ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2819
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Country | US
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Telephone | 954-436-3880
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Fax | 954-436-3881
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARLOS EDUARDO PLASENCIA
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Credential | PHD, LMHC
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Telephone | 954-436-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH0002618
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS757
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT0001579
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW8336
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License Number State | FL
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