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General NPI Number Information
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NPI Number | 1497212955
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Entity Type | Organization
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Legal Business Name | ALTIS COUNSELING LLC
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 11820 MIRAMAR PKWY STE 304
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City | MIRAMAR
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State | FL
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Zip | 33025-5820
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Country | US
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Telephone | 786-886-4631
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 772002
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City | OCALA
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State | FL
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Zip | 34477-2002
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Country | US
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Telephone | 786-886-4631
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Fax | 720-265-9580
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. EVA ABAD
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Credential | LMHC
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Telephone | 786-838-9568
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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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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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