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General NPI Number Information
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NPI Number | 1144838269
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Entity Type | Organization
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Legal Business Name | PEACE AT LAST COUNSELING, LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 415-401
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 561-406-9915
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Fax |
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Provider Business Mailing Address
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Address Line | 9050 PINES BLVD STE 415-401
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 561-406-9915
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Fax |
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Authorized Official
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Title or Position | CEO/PSYCHOTHERAPIST
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Name | DANIELLA N. SHAW
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Credential | LCSW
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Telephone | 561-406-9915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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