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General NPI Number Information
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NPI Number | 1558752642
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Entity Type | Organization
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Legal Business Name | NEXTEP COUNSELING AND CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 6313 CORPORATE CT STE 130
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City | FORT MYERS
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State | FL
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Zip | 33919-3509
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Country | US
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Telephone | 239-362-0144
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Fax |
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Provider Business Mailing Address
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Address Line | 6313 CORPORATE CT STE 130
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City | FORT MYERS
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State | FL
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Zip | 33919-3509
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Country | US
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Telephone | 239-362-0144
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA RAAB
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Credential |
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Telephone | 239-362-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 2036AD6563-01
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License Number State | FL
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