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General NPI Number Information
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NPI Number | 1184137051
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Entity Type | Organization
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Legal Business Name | NOVA COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 2500 S KANNER HWY STE 2
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City | STUART
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State | FL
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Zip | 34994-4600
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Country | US
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Telephone | 772-212-5327
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Fax | 772-320-1557
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Provider Business Mailing Address
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Address Line | 765 SW MCCOMB AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-3902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | PILAR GUTIERREZ
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Credential |
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Telephone | 772-320-1557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 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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