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General NPI Number Information
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NPI Number | 1134984321
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Entity Type | Organization
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Legal Business Name | SELF CARE COUNSELING OF SOUTH FLORIDA, INC.
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 8461 LAKE WORTH RD #205
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City | LAKE WORTH
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State | FL
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Zip | 33467
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Country | US
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Telephone | 954-667-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 13762 W STATE ROAD 84 UNIT 159
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City | DAVIE
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State | FL
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Zip | 33325-5305
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Country | US
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Telephone | 954-667-9844
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMIE KATHLEEN SOCKOL
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Credential | LMHC
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Telephone | 954-531-2338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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