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General NPI Number Information
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NPI Number | 1396025615
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Entity Type | Organization
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Legal Business Name | SAFE PLACE COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 2103 MUD LAKE RD
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City | PLANT CITY
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State | FL
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Zip | 33566-1009
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Country | US
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Telephone | 813-752-4591
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Fax | 813-752-3092
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Provider Business Mailing Address
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Address Line | 2020 CEDAR RUN
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City | PLANT CITY
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State | FL
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Zip | 33563-1447
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Country | US
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Telephone | 813-767-1923
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Fax | 813-752-3092
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Authorized Official
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Title or Position | OWNER/SHAREHOLDER
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Name | MRS. JENNIFER MAE ZEIGLER
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Credential | LMHC
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Telephone | 813-767-1923
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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 | MH10534
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License Number State | FL
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