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General NPI Number Information
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NPI Number | 1336613363
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Entity Type | Organization
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Legal Business Name | GREAT MINDS COUNSELING LLC
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Dates
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Enumeration Date | 01/12/2019
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Last Update Date | 07/07/2019
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Provider Practice Location Address
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Address Line | 1217 WHITE ST
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City | KEY WEST
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State | FL
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Zip | 33040-3367
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Country | US
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Telephone | 305-497-7335
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BLUE WATER DR
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City | KEY WEST
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State | FL
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Zip | 33040-6103
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Country | US
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Telephone | 786-659-6571
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | COLLEEN SULLIVAN
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Credential | M.ED LMHC
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Telephone | 305-497-7335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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