=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457140220
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE COUNSELING GROUP OF MIAMI, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2025
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2840 SW 3RD AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33129-2317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 58-570-0503
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 GOODLETTE-FRANK RD N STE C206
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5666
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-857-0050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GERALYN CECOLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 574-238-5480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------