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General NPI Number Information
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NPI Number | 1336842293
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Entity Type | Organization
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Legal Business Name | THREE HEART BEATS COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 10100 W SAMPLE RD STE 300
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3973
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Country | US
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Telephone | 561-244-2553
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Fax | 561-258-9123
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Provider Business Mailing Address
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Address Line | 10100 W SAMPLE RD STE 300
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3973
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Country | US
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Telephone | 561-244-2553
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Fax | 561-258-9123
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | WILIETTE DEBRA SEJOUR-THELISMON
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Credential | LCSW
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Telephone | 561-244-2553
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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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