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General NPI Number Information
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NPI Number | 1518036102
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Entity Type | Organization
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Legal Business Name | THE COUNSELING CENTER OF KEY WEST INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 1111 12TH STREET SUITE 206
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City | KEY WEST
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State | FL
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Zip | 33040
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Country | US
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Telephone | 305-294-8777
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Fax | 305-294-8298
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Provider Business Mailing Address
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Address Line | 1111 12TH STREET SUITE 206
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City | KEY WEST
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State | FL
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Zip | 33040
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Country | US
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Telephone | 305-294-8777
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Fax | 305-294-8298
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RONALD EMILE ERSAY
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Credential | MD
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Telephone | 305-294-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME17888
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License Number State | FL
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