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General NPI Number Information
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NPI Number | 1245064955
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Entity Type | Organization
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Legal Business Name | HYBRID COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 2469 N YOUNG BLVD
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City | CHIEFLAND
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State | FL
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Zip | 32626-9181
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Country | US
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Telephone | 352-890-2182
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Fax |
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Provider Business Mailing Address
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Address Line | 4429 SW COUNTY ROAD 344
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City | BELL
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State | FL
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Zip | 32619-1781
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Country | US
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Telephone | 352-890-2182
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNALIESE FOSTER
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Credential | LMHC
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Telephone | 352-890-2182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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