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General NPI Number Information
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NPI Number | 1467801639
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Entity Type | Organization
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Legal Business Name | COUNSELING FOR THE HEALING MIND
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2240 W WOOLBRIGHT RD SUITE 351
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6332
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Country | US
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Telephone | 724-301-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 7837 VENTURE CENTER WAY APT 5212
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-7414
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Country | US
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Telephone | 724-301-0311
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. PATRICIA MARIE MESSINA
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Credential | M.S.W., L.C.S.W
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Telephone | 724-301-0311
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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 | SW12554
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License Number State | FL
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