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General NPI Number Information
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NPI Number | 1528741279
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Entity Type | Organization
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Legal Business Name | FRIEND OF A FRIEND COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 06/16/2024
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Provider Practice Location Address
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Address Line | 1990 MAIN ST STE 750
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City | SARASOTA
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State | FL
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Zip | 34236-8000
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Country | US
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Telephone | 941-724-4784
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1045
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City | DYERSBURG
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State | TN
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Zip | 38025-1045
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Country | US
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Telephone | 941-724-4784
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ALICE MARIE LIGHT
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Credential | LCPC; PHD
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Telephone | 941-724-4784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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