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General NPI Number Information
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NPI Number | 1457122038
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Entity Type | Organization
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Legal Business Name | FLORIDA COAST COUNSELING LLC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 3443 PINE RIDGE RD STE 101
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City | NAPLES
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State | FL
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Zip | 34109-3926
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Country | US
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Telephone | 239-427-1833
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Fax |
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Provider Business Mailing Address
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Address Line | 2430 VANDERBILT BEACH RD STE 108
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City | NAPLES
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State | FL
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Zip | 34109-2654
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Country | US
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Telephone | 239-427-1833
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Fax |
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Authorized Official
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Title or Position | CO-OWNER / PSYCHOLOGIST
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Name | DR. REBECCA ANDERSON
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Credential | PHD
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Telephone | 413-246-5499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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