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General NPI Number Information
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NPI Number | 1245037399
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Entity Type | Organization
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Legal Business Name | TRIUMPH MENTAL HEALTH COUNSELING, LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 271 IMPERIAL LN
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City | LAUDERDALE BY THE SEA
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State | FL
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Zip | 33308-5924
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Country | US
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Telephone | 954-478-9328
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Fax |
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Provider Business Mailing Address
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Address Line | 271 IMPERIAL LN
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City | LAUDERDALE BY THE SEA
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State | FL
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Zip | 33308-5924
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Country | US
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Telephone | 954-478-9328
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | MS. JEANNINE PEARCE CLARK
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Credential | LMHC
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Telephone | 954-478-9328
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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 |
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License Number State |
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